Most COPD patients are not using their inhalers correctly which is contributing to poor patient outcomes, a large confirms .
The French study of almost 3,000 patients observed using their inhalers by GPs or respiratory physicians, found more than 50% of patients were not using their devices correctly – regardless of the type of device.
In patients treated for at least three months, those who made critical errors in their inhaler technique were twice as likely to experience severe exacerbations requiring emergency department presentations or hospital admissions.
Professor Helen Reddel, from the Woolcock Institute of Medical Research, told the limbic the findings were unsurprising given the experience in asthma.
“In asthma we have found that about 80% of patients have incorrect technique, so if anything the 50% finding is not an underestimate. We assume patients have incorrect technique unless proven otherwise,” she said.
“This study also confirms other research findings that incorrect inhaler technique in both asthma and COPD is contributing to worse outcomes.”
She said patients slipped through the gaps when there was no clear indication about which members of the health team were responsible for providing inhaler technique training.
“There has been a huge emphasis since 2014 when the national asthma guidelines were updated about checking and correcting inhaler technique before considering any step-up in medication. The same is recommended in COPD guidelines.”
While there were many educational resources available, she said they didn’t substitute for a health professional sitting down with a patient, watching how they use their inhaler, demonstrating the correct technique, and checking and rechecking the patient’s technique.
“We’ve found repeating the training procedure up to three times can improve asthma outcomes,” she said.
Common errors identified in the French study included failure to breathe out before actuation, inhalation through the nose and not holding the breath for a few seconds after inhalation.
“We’ve also recently shown that even after learning the correct technique, inhaler technique drops off quickly. It really needs to be checked at every visit,” Professor Reddel said.
For handy resources on inhaler techniques go to:
National Asthma Council inhaler videos:
https://www.nationalasthma.org.au/health-professionals/how-to-videos
Brochure re: inhaler technique in asthma and COPD.
https://assets.nationalasthma.org.au/resources/Infopaper-FULL-UPDATED-11-1.pdf
NAC checklists: