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30-07-2013 | Respiratory | Article

Regular follow up key to asthma inhalation technique


Free abstract

medwireNews: Researchers in Turkey have found that regular follow up and correction of inhaler technique significantly improves patient asthma control over 6 months.

“Our findings emphasize the crucial role of regular assessment and reinforcement of correct inhalation technique by [the] entire health-care team particularly the prescribing clinician and the dispensing pharmacist who have primary responsibility for patient education and should themselves retain the skills to operate the various devices,” says author Fusun Yildiz (Kocaeli University School of Medicine).

Yildiz and colleagues from the ASIT (Asthma Inhaler Treatment) study group assessed 572 asthma patients, who were using a variety of combination inhaler devices, over four consecutive visits at baseline and months 1, 3, and 6. At each visit, patients and physicians assessed asthma technique using the researchers’ Ease of Use for the Inhaler Device Questionnaire and patients were corrected by a physician on any mistakes in their inhalation technique.

The rate of asthma control, according to the Asthma Control Test (ACT), increased from 61.5% at baseline to 87.3% at the end of follow up.

And, the researchers found that this was accompanied by significant decreases in inhaler technique errors. At baseline, the most common error was failure to exhale before inhaling through the device, which was reported by 18.5% of patients, but this fell to 6.5% by the end of the study. Additionally, failure to hold breath for 5 to 10 seconds after inhalation fell from 13.6% to 3.7%, and failure to rinse mouth with water after inhaling the drug fell from 16.8% to 5.6%.

The researchers report that, in particular, reducing the number of inhalation technique errors to one or zero was associated with improved asthma control. For example, at the end of the study, all but one patient using a turbuhaler device (n=83) had achieved this level of administration accuracy, 85.4% of whom were deemed to have good asthma control (ACT score ≥20).

Writing in Respiratory Care, Yildiz says that although “technical features of inhaler devices have improved constantly with time, the effectiveness in delivering drugs to the lungs has been considered to depend on correctly performed inhalation maneuvers.”

She notes that international studies have repeatedly found that a substantial proportion of asthma patients do not receive inhaler technique education or receive it in a limited capacity without routine reinforcement.

Cautioning that healthcare professionals must first confirm their own correct use of available combination devices, Yildiz concludes that the study demonstrates “the positive role of regular monitoring in better clinical efficacy and disease control via achievement of good compliance to inhaler treatment and proper handling of inhalers in asthma patients.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter

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