In recent weeks, we have witnessed the implementation of progressive deconfinement. The fear of a second wave of coronavirus infection is still present and the increase in cases in different parts of the world reminds us of the importance of remaining vigilant. It is essential to continue to adhere to the preventive measures issued by public health. A reminder is never too much to reinforce good habits.
In this same context, we would like to take the opportunity to remind you of an essential basic element in the maintenance treatment for respiratory diseases, namely inhaled medication techniques. The better you master your inhaler technique, the better the treatment will be, and consequently, the better you will breathe.
Why Are Inhaler Techniques Important?
Asthma and COPD are respiratory diseases whose treatment requires medication to get to the lungs. This is why inhalers are used. Inhalers allow these medications to go directly into the lungs, but only if they are taken properly. Figures may vary between studies, but some report that up to 94% of patients do not use their inhalers correctly1. As a result, this means that respiratory diseases are not being treated optimally. Poor inhaler technique is associated with a significant increase in risk of hospitalizations, emergency room visits, antibiotic therapy and oral corticosteroid therapy2.
How to Improve Inhaler Technique
Despite the development of several new types of devices over the past 40 years, we are unfortunately still not seeing any lasting improvement in their use by patients3. It has been known for several years that the distribution of written instructions is useful, but insufficient to bring individuals to a level of proper use of their devices. It is recommended to educate through demonstrations as well as supervised practice.
In an Australian study, 75% of patients who used an inhaler for an average of two to three years reported using their inhaler correctly, but upon an objective verification, only 10% demonstrated proper technique4.
Moreover, data suggests that only 7% of healthcare professionals are able to demonstrate all of the correct steps to use an inhaler.
For Healthcare Professionals: It is a good idea to learn how to use each inhaler device correctly and to be aware of common errors so you can demonstrate this properly to patients. Systematic monitoring of patients’ inhaler techniques should also be implemented.
For patients: Bring your inhalers with you to your appointments and do not hesitate to ask your healthcare professionals questions about your technique. The optimization of a single detail of your inhaler technique could greatly improve your quality of life.
To help you, you can watch the following videos on inhaler techniques. For educators, you may also be interested in one of the following training programs or webinars offered by the RQESR and eXpand Courses.
References:
- 1. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593-604. doi:10.1016/j.rmed.2007.11.003
- 2. Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. Published 2018 Jan 16. doi:10.1186/s12931-017-0710-y
- 3. Sanchis J, Gich I, Pedersen S; Aerosol Drug Management Improvement Team (ADMIT). Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time?. Chest. 2016;150(2):394-406. doi:10.1016/j.chest.2016.03.041
- 4. Basheti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Educ Couns. 2008;72(1):26-33. doi:10.1016/j.pec.2008.01.014
- 5. Baverstock M, Woodhall N, Maarman. VP94 Do healthcare professionals have sufficient knowledge of inhaler techniques in order to educate their patients effectively in their use?. Thorax 2010;65:A117-A118.
About the author
Dr. Josianne Hamel Bourbeau completed her medical studies and her specialization in family medicine at the University of Montreal. Her practice is versatile and diverse, as are her interests. She currently works at the GMF Ahunstic and at the Centre d’hébergement Notre-Dame-de-la-Merci in the CIUSSS du Nord-de-l’Île-de-Montréal, and at the Saint-Eustache Hospital in the CIUSSS des Laurentides. She is also involved in hospital teaching for undergraduate medical students for the University of Montreal. She firmly believes in the power of sharing medical knowledge to patients and between professionals in order to provide sustainable quality health care for all.
