Inhalers in pulmonary medicine

Q: A 21-year-old male with a history of Asthma is admitted again to ICU with exacerbation of his symptoms. Patient insists that he takes his prescribed medicines and inhalers religiously. Almost half of the patients used their inhalers incorrectly.

A) True

B) False

 

Answer: A

One area where clinicians failed miserably is instructing patients on using inhalers correctly. This results in higher hospitalizations and emergency room visits. Less appreciated is that it also increases the domino effects of blood glucose issues and obesity due to frequent oral steroid courses. 

Multiple studies have established that less than one-half of the patients used their inhalers correctly. Interestingly, in the last four decades, despite increased presumed education, there is little to no improvement in rates of correct inhaler technique!

#pulmonary

 

References:

1. Price DB, Román-Rodríguez M, McQueen RB, et al. Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract 2017; 5:1071.

2. 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; 150:394.

3. Al-Jahdali H, Ahmed A, Al-Harbi A, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol 2013; 9:8.