Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method

Abstract

Incorrect inhalation technique is common among asthma and COPD patients in a pulmonary outpatient clinic. Our study suggests that the use of prefilled dry powder inhalers as well as inhalation instruction increases correct inhalation technique. Simultaneous use of different types of inhalation devices has to be discouraged.

Inhaler technique: does age matter? A systematic review

“…Studies differed according to methodology, with 10 employing an observational, cross-sectional methodology [4,5,7,[19][20][21][22][23][24][25], one an observational, comparative, cohort methodology spanning 18 months [26], one a comparative, cross-sectional methodology employing a community intervention [27], one a comparative, cohort study employing a community intervention spanning 4 weeks [28], and one employing a randomised-controlled-trial cohort design spanning 6-10 weeks (supplementary table S2) [29].…”

“…DAHL et al [28] employed a 12-point inhaler technique checklist in a cohort of 151 patients, identifying an increase in the percentage of patients demonstrating errors from 50% to 55% and 63% in patients aged 43-65 years, 66-71 years and 72-85 years, respectively; however, statistical significance was unreported. ARMITAGE and WILLIAMS [26] WIESHAMMER and DREYHAUPT [24]: Accuhaler WIESHAMMER and DREYHAUPT [24]: Turbuhaler GIRAUD and ROCHE [4] DAHL et al [28] MOLIMARD et al [19] ROOTMENSEN et al [22] FIGURE 2 Graphical representation of percentage of participants performing inhaler technique errors according to age.…”

“…Eight studies explored the impact of age on proficiency in inhaler technique across a range of DPI devices [5,19,[21][22][23][24][25]28]. Seven employed a cross-sectional, observational methodology [5,19,[21][22][23][24][25], and one a cohort community intervention conducted over 4 weeks [28].…”

“…Seven employed a cross-sectional, observational methodology [5,19,[21][22][23][24][25], and one a cohort community intervention conducted over 4 weeks [28]. A range of DPI devices were analysed collectively in four studies [5,[21][22][23], and individually in three investigations [19,25,28].…”

“…Inhaler technique was assessed by investigators [5,22,23,28], research assistants [25], a trained pulmonary technician, or either a GP [19] or GP assistant [21] via reference to standardised investigator-formulated or national [21] inhaler technique checklists employing direct observation or triplicate referral of a video-recording of technique. A positive association between error frequency and age was identified in six studies, with statistical significance identified in five, unreported in one, and unidentified in the latter study [25].…”