OBJECTIVE: To describe errors in inhaler technique of patients with chronic obstructive pulmonary disease (COPD). SETTING: Outpatient clinic, Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands. DESIGN: Descriptive. METHOD: Adult COPD patients who already used an inhaler were asked to demonstrate their inhaler technique. Using a inhaler-specific checklist errors were registered. A division was made into good, adequate and inadequate technique. For each inhaler a selection of critical actions with regard to effective inhaler technique was made. RESULTS: Inhaler technique was assessed in 123 COPD patients. Over one-third of all patients had a very poor inhaler technique, which probably resulted in little or even no drug deposition at all. 42% of the patients performed all essential inhaler actions correctly. For patients with a Diskhaler this was 86%, significantly higher than for the other inhalers, Rotahaler and Turbuhaler, which did not differ much (35% and 46%). Poor inhalation technique leads to insufficient bronchodilating or prophylactic effect, to the prescription of more or additional medication with a higher probability of side effects, and to increased costs. CONCLUSION: The inhalation technique can be improved substantially with a good instruction protocol.
OBJECTIVE: To describe errors in inhaler technique of patients with chronic obstructive pulmonary disease (COPD). SETTING:Outpatient clinic, Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands. DESIGN: Descriptive. METHOD: Adult COPDpatients who already used an inhaler were asked to demonstrate their inhaler technique. Using a inhaler-specific checklist errors were registered. A division was made into good, adequate and inadequate technique. For each inhaler a selection of critical actions with regard to effective inhaler technique was made. RESULTS: Inhaler technique was assessed in 123 COPDpatients. Over one-third of all patients had a very poor inhaler technique, which probably resulted in little or even no drug deposition at all. 42% of the patients performed all essential inhaler actions correctly. For patients with a Diskhaler this was 86%, significantly higher than for the other inhalers, Rotahaler and Turbuhaler, which did not differ much (35% and 46%). Poor inhalation technique leads to insufficient bronchodilating or prophylactic effect, to the prescription of more or additional medication with a higher probability of side effects, and to increased costs. CONCLUSION: The inhalation technique can be improved substantially with a good instruction protocol.
Authors: Ruben D Restrepo; Melissa T Alvarez; Leonard D Wittnebel; Helen Sorenson; Richard Wettstein; David L Vines; Jennifer Sikkema-Ortiz; Donna D Gardner; Robert L Wilkins Journal: Int J Chron Obstruct Pulmon Dis Date: 2008