Reply: Effective Inhaler Training Is Critical.

From the Authors:

We wholeheartedly agree with Press and colleagues that more resources must be dedicated to skill-training interventions aimed at improving inhaler technique. As mentioned in their letter, the work done by Press and colleagues demonstrates the effectiveness of inhaler training to reduce emergency department visits and readmissions among patients with severe disease (1). The findings of our paper build on their work by suggesting that improving inhaler technique would likely benefit patients with mild or moderate disease (2). We found that patients with adequate inhaler technique were less likely to experience overuse of inhaled corticosteroid and therefore would be less likely to experience the adverse consequences of inhaled steroid use (e.g., pneumonias and fractures) (3, 4). Research to evaluate and implement effective inhaler skill-training interventions may not just improve patients’ quality of life but may also save healthcare resources and unnecessary patient suffering over the long term from avoidable hospitalizations and adverse effects from unnecessary medications.