The ADMIT series--Issues in Inhalation Therapy. 7. Ways to improve pharmacological management of COPD: the importance of inhaler choice and inhalation technique.

Since inhalation therapy will probably remain the preferred route of treatment for patients with chronic obstructive pulmonary disease (COPD), it is important to provide helpful information that may assist physicians and nurses in selecting the appropriate device(s) for individual patients as well as prescribing the correct medication. In line with the GOLD guidelines, the Aerosol Drug Management Improvement Team (ADMIT) propose a three-part "therapy adjustment strategy", which provides health care professionals with a way to monitor and check the delivery of inhaled medication. The strategy is a summation of the key principles behind the evidence-based management of stable COPD and exacerbations. It offers physicians a rapid and user-friendly overview of the requirements of COPD management starting with making the diagnosis and continuing with optimisation of therapy in follow-up appointments. It includes everything from check lists for disease assessment and recommendations for reducing risk factors to selecting the proper inhalers and continuous checking of compliance and correct inhaler technique. These practical COPD therapy adjustment algorithms have been used as part of an interactive online course developed by the ADMIT group (www.admit-online.info). The COPD "flash" video available at this web site offers suggestions on how to organise a complete doctor-patient consultation.