Inhaler technique, a long time week spot
Mastering inhaler technique is tricky, and a large review assessing 144 studies with roughly 60,000 subjects observed for inhaler technique during the last 40 years reveals no significant improvement of inhaler technique over time, with constantly ~3/10 of patients having an inhaler technique that is correct, ~4/10 being acceptable and ~3/10 being poor [1]. When looking at patients that uses multiple inhalers the problem of poor inhaler technique becomes even worse. A recent Swedish study shows that 7/10 that uses 2 or more devices make one or more critical errors when using their inhalers [2].
Ideas for improving inhaler technique
Tackling this persistent problem is important as correct inhaler technique is crucial to obtain disease control. There is no easy fix to this, but combined today’s speakers at this session recommends the following:
- Learn the technique: As a healthcare professional you need to be comfortable with the inhaler technique of all the devices used!
- Teach the technique: Make sure the patient is comfortable with the device they are using. Ask the patient to show how they take their inhaler at every single visit.
- With or without spacer? If spacer is prescribed, dare to ask if it is used every time – if not, explain that this is crucial as spray inhaler technique is very different with and without spacer.
- Reduce the number of inhalers that a patient uses – ideally use one, if possible.
- Motivate: Explain to the patient why correct inhaler technique is critical for their treatment – that it influences how much medication they are receiving and how well it deposits in the lungs.
Achieving correct inhaler technique is a combined responsibility between healthcare professionals incl. general practicians, nurses and specialist, patients, pharmacists, and patient associations. Stated by the speakers – ensuring correct inhaler technique must be a main focus at each interaction between asthma/COPD patients and healthcare professionals.
Nicolai Krogh
Medical Science Liaison, Chiesi Nordic
References
- Sanchis J, Gich I, Pedersen S; Aerosol Drug Management Improvement Team (ADMIT). Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time? Chest. 2016 Aug;150(2):394-406. doi: 10.1016/j.chest.2016.03.041. Epub 2016 Apr 7. PMID: 27060726.
- Sulku J, Bröms K, Högman M, Janson C, Lisspers K, Malinovschi A, Melhus H, Ställberg B, Nielsen EI. Critical inhaler technique errors in Swedish patients with COPD: a cross-sectional study analysing video-recorded demonstrations. NPJ Prim Care Respir Med. 2021 Feb 9;31(1):5. doi: 10.1038/s41533-021-00218-y. PMID: 33563979; PMCID: PMC7873256.
ID 10076-17.09.2024