Inhalers for COPD Treatments Often Used Incorrectly, Small Study Finds

Fewer than 30% of devices used properly by 300 COPD, asthma patients at center

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Many people with chronic obstructive pulmonary disease (COPD) or asthma use their inhaler therapies incorrectly, according to a recent study conducted at a center in Turkey.

“The misuse of inhalers has been an obstacle to both patients and clinicians for many years and unfortunately still remains a significant issue,” the researchers wrote.

They called for clinicians to be more active in assessing the way patients requiring these therapies use their inhalers.

“Each patient’s visit should be taken as an opportunity to evaluate the patient’s inhaler use in order to correct their technique and optimize treatment,” the scientists wrote.

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The study, “An evaluation of the use of inhalers in asthma and chronic obstructive pulmonary disease,” was published in the Journal of Taibah University Medical Sciences.

Inhaled therapies are a key part of treatment for lung diseases like COPD and asthma, allowing medications to be directly administered to the lungs where they are needed. To be maximally effective, however, inhalers need to be used correctly — and with over 250 inhaled therapy devices currently commercially available, it can be easy to make unintended mistakes.

A team of researchers in Ankara evaluated inhaler device use in 300 adults, including 113 with COPD and 187 with asthma. All had been using an inhaled therapy for at least six months; the median duration of use was four years.

“Our primary aim was to evaluate inhaler techniques in patients with asthma and COPD in order to identify common errors,” the scientists wrote.

These 300 people were collectively using a total of 440 inhaled devices, all of which were evaluated separately. Results showed that only 131 devices (29.8%) were used correctly, while the other 309 (70.2%) were used incorrectly.

The most common type of error was patients failing to breathe out, emptying the lungs of air before inhaling to administer the therapy. Other common errors included patients not holding their breath after inhaling and, for certain devices, not shaking the device before administering the therapy.

“This study draws attention to the steps where the most frequent mistakes were made in inhaler use,” the researchers wrote, stressing that these errors could make treatment less effective, leading to worse disease control.

The rate of incorrect use was higher in patients over the age of 60 compared with younger patients, and was lower in those who had received more formal education, but did not differ significantly according to gender, disease type (asthma or COPD), or duration of inhaler use. Notably, patients who self-reported watching instructional videos about inhaler use on the internet tended to use their devices correctly.

Rates of misuse also varied by inhaler type: metered dose inhalers were less likely to be used correctly compared with dry powder inhalers.

Despite the high rate of incorrect inhaler use, most patients reported being satisfied with their inhaler medication. According to researchers, “this highlights that a patient’s satisfaction with their inhaler does not mean that they use it correctly and effectively.”

They also noted that this was a comparatively small study done at a single center, and its findings shouldn’t be overly generalized. Nonetheless, they highlight the importance of clinicians assessing inhaler technique and use, and working to correct any errors so that patients can get the maximum possible benefit from their treatments.