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Respiratory Health Q2 2022

The importance of establishing good inhaler technique

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Ravijyot Saggu

Chair, UK Clinical Pharmacy Association Respiratory Committee
Clinical pharmacist, University College London Hospital NHS Foundation Trust

Many respiratory conditions such as asthma or chronic obstructive pulmonary disease require inhaled therapy.

Inhalers are convenient and enable the medicine to be delivered exactly where it needs to go. But research suggests that up to 90% of people don’t use their inhalers correctly.

This can be due to a number of factors such as the design of the inhaler, how well the patient is able to physically handle the inhaler and whether they are able to coordinate inhaling at the same time as operating the inhaler.

Good inhaler technique is vital to ensure that as much of the medicine as possible is delivered to the lungs. Less than optimal technique can lead to poor disease control and quality of life, increased potential for side effects, more hospital admissions and increased costs of healthcare treatment.

Different inhalers require different techniques

There are many types of inhalers available. These mainly fall into two categories: aerosol metered dose inhalers (MDI) or dry powder inhalers (DPI). The technique required varies for different devices.

MDIs are commonly prescribed and they require slow, steady inhalation. But many patients aren’t taught how to use the device properly, or they struggle to use it (although this is improved by using a spacer device). This means that the medicine can’t reach where it needs to work and is therefore ineffective.

Good inhaler technique is vital to ensure that as much of the medicine as possible is delivered to the lungs.

Conversely, DPIs require a fast, deep inhalation. They also don’t contain propellant gases (which contribute to global warming) and may be a more suitable option. However, it is important to discuss with the patient and prescribe the device which is most suitable.

Training from healthcare professionals

Patients may not have been instructed on correct inhaler use or, despite this, may still be unable to use them. Almost everyone can learn good technique with adequate training and practice. Training from healthcare professionals (HCPs) should be repeated regularly to ensure that the patient continues to use the inhaler correctly in order to remain well.

Support and resources are available to help with this. Technique can be checked by asking the patient to demonstrate at treatment initiation and as part of their regular review.

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