Inhalers play a leading role in helping to manage asthma and chronic obstructive pulmonary disease (COPD). Indeed, they can even be lifesaving! But to do their job of delivering medication, they do need to be used correctly. So it is concerning to read a study from the University of Chicago that shows how the majority of patients do not use their inhaler as intended.

The researchers asked 100 adults who had been hospitalised for either asthma or COPD (so we can assume they had severe disease) to demonstrate how they actually used their inhalers. Most of them made some kind of error. The good news is that it didn’t take very long for them to learn how to use their inhalers in the right way.

There are two types of inhaler - preventers and relievers. A preventer protects the airways and reduces the risk of an asthma attack. A reliever is the one you use when you are having an attack - it gets rid of the symptoms. There are several different designs of inhaler. This study involved a metered-dose inhaler and a Diskus inhaler. The metered-dose inhaler is mainly used as both preventer and reliever while the Diskus inhaler is used as a preventer. The important point is that they are used in different ways. Since many patients with asthma will have both types, it’s important to be aware of the differences. With the metered dose inhaler, you have to inhale slowly. With the Diskus, you inhale sharply. In this study, metered-dose inhalers were used incorrectly nearly nine out of ten times, and Diskus inhalers seven out of ten times. The main error was failing to breathe out completely before using the inhaler.

Eyesight seemed to be an issue as well. Nearly all of those with vision problems did not use the Diskus inhaler correctly, compared to more than half of those with no vision problems. It might be that people with poor eyesight have difficulty reading the instructions for the inhaler, as these tend to be written in small print.

Half of the participants were then taken aside and given a lesson on how to use the inhaler. Within a very short time, all had mastered the technique for both type of inhaler.

Next to the regular best practice non medical treatment for asthma, it is so important to be using your medication correctly if you have asthma or COPD. If your symptoms are not well controlled, could the reason be that you are not using your inhaler correctly? Ideally, your doctor should have shown you how, but this doesn’t always happen. Don’t be afraid to ask questions if you are not sure and don’t assume that you are doing it right! This video from AsthmaUK shows how to use several inhalers, including the metered dose. There are instruction on how to use a Diskus inhaler.

Source:

Press V et al. Misuse of respiratory inhalers in hospitalized patients with asthma or COPD

Journal of General Internal Medicine online January 19 2011