OBJECTIVE: To identify incorrect inhaler techniques employed by patients with respiratory
diseases in southern Brazil and to profile the individuals who make such errors.
METHODS: This was a population-based, cross-sectional study involving subjects ≥ 10 years
of age using metered dose inhalers (MDIs) or dry powder inhalers (DPIs) in 1,722
households in the city of Pelotas, Brazil. RESULTS: We included 110 subjects, who collectively used 94 MDIs and 49 DPIs. The most
common errors in the use of MDIs and DPIs were not exhaling prior to inhalation
(66% and 47%, respectively), not performing a breath-hold after inhalation (29%
and 25%), and not shaking the MDI prior to use (21%). Individuals ≥ 60 years of
age more often made such errors. Among the demonstrations of the use of MDIs and
DPIs, at least one error was made in 72% and 51%, respectively. Overall, there
were errors made in all steps in 11% of the demonstrations, whereas there were no
errors made in 13%.Among the individuals who made at least one error, the
proportion of those with a low level of education was significantly greater than
was that of those with a higher level of education, for MDIs (85% vs. 60%; p =
0.018) and for DPIs (81% vs. 35%; p = 0.010). CONCLUSIONS: In this sample, the most common errors in the use of inhalers were not exhaling
prior to inhalation, not performing a breath-hold after inhalation, and not
shaking the MDI prior to use. Special attention should be given to education
regarding inhaler techniques for patients of lower socioeconomic status and with
less formal education, as well as for those of advanced age, because those
populations are at a greater risk of committing errors in their use of
inhalers.