Incorrect inhaler techniques in Western India: still a common problem

Abstract

Background: To assess and evaluate the incorrect use of inhalers in patients with asthma and chronic obstructive pulmonary disease (COPD) in the outpatient department of pulmonary medicine at RUHS college of medical sciences Jaipur, Rajasthan, India.Methods: Patients visiting the outpatient department of respiratory medicine were asked to demonstrate the inhaler technique and were assessed by the physician.Results: The study included 200 patients with Asthma or COPD. Among patients with COPD, 80 (63.4%) were males and 46 (36.5%) were females. In the asthma group, there were 50 (67.5%) females and 24 (32.4%) males. Patients with COPD were in the age group between 46-82 years with a mean age of 64 years while patients with asthma were in the age group between 18-70 years with a mean age of 44 years. Only 28 (14%) patients could perform all steps correctly in use of inhaler devices. 172 patients (86%) were unable to use inhalers properly. Most common error for metered dose inhalers (MDIs) was in step 7 that is (i.e.) not holding breath for 10 seconds which was seen in 46 patients (51.7%). The most common error seen for dry powder inhalers (DPIs) was in step 5 i.e. exhalation to residual volume before inhalation seen in 50 patients (47.1%).Conclusions: This study revealed that majority of patients use the inhaler devices incorrectly. Proper education regarding inhaler use is crucial for effective treatment with use of these inhaler devices.

Pharmacist Led Intervention on Inhalation Technique among Asthmatic Patients for Improving Quality of Life in a Private Hospital of Nepal

“…In this study, the most frequently performed error in inhalation technique was in step 7 (hold breath for 10 s or if possible) and step 8 (Wait for at least one minute before taking the second dose). is nding is in agreement with another study done by Sodhi [13] in India. e majority of the patients were unable to hold breath for 10 s may be because of decreased pulmonary function due to asthma.…”

“…e checklists adapted from Sodhi et al for MDI and DPI are an excellent tool to assess the correct use of these devices by patients and health care professionals [13]. MDI consists of total eight steps and DPI consists of eleven steps in which correct steps performed were given score one and incorrect steps performed were given score zero.…”

Evaluation of Inhaler Technique amongst Asthmatic and COPD Patients Attending a Tertiary Care Hospital

“…Non-synchronization between the act of actuation of the device and deep inhalation (step 6) was still another important error seen. In a study by Sodhi et al [19] (2017), most common error for MDI was not holding breath for 10 seconds which was seen in 46 patients (51.7%), while in a study by Ammari et al [20] (2015), step 2 (shake the inhaler) and step 6 (Inhale slowly while actuating the device and continuing inhalation) were most common errors in MDI use.…”

Practice on Meter Dose Inhaler Techniques and Its Associated Factors Among Asthmatic Patients at Debre Markos Comprehensive Specialized Hospital, East Gojjam, Ethiopia: A Prospective Study.

“…Three (3.3%) patients did not remove the cap from the canister and were unable to hold the inhaler upright . 15 The result of a research done at different hospitals in Abu Dhabi also showed the attitude of patients towards asthma and their behavior regarding the use of inhalers and preventive therapy, 57% of patients usually seek medical care for treatment of asthma. 59% of asthma patients did not use anti-inflammatory drugs in the form of steroid inhalers when prescribed because they were afraid of lifelong dependence on inhalers.…”