References

Al-Jahdali H, Ahmed A, Al-Harbi A Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy, Asthma & Clinical Immunology. 2013; 9:(1) https://doi.org/10.1186/1710-1492-9-8

British Thoracic Society/Scottish Intercollegiate Guidelines Network. SIGN158 British guideline on the management of asthma. 2019. http://www.sign.ac.uk (accessed 15 April 2020)

Dekhuijzen PNR, Vincken W, Virchow JC Prescription of inhalers in asthma and COPD: Towards a rational, rapid and effective approach. Respiratory Medicine. 2013; 107:(12)1817-1821 https://doi.org/10.1016/j.rmed.2013.09.013

Improving inhaler technique – who needs teaching?. https://doi.org/10.1136/dtb.2012.10.0131

Fleming ND, Mills C. Helping Students Understand How They Learn.Madison, Wisconsin, USA: Magma Publications; 1992a

Fleming ND, Mills C. Not Another Inventory, Rather a Catalyst for Reflection. To Improve the Academy. 1992b; 11:137-155

Global Initiative for Asthma. Pocket guide for asthma management and prevention. 2019. http://www.ginasthma.org (accessed 15 April 2020)

Global Initiative for Chronic Obstructive Lung Disease. Pocket Guide to COPD diagnosis, management and prevention. 2019. http://wwwgoldcopd.org (accessed 15 April 2020)

Melani AS, Bonavia M, Cilenti V Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine. 2011; 105:(6)930-938 https://doi.org/10.1016/j.rmed.2011.01.005

National Review of Asthma Deaths. Why asthma still kills. 2014. http://www.rcplondon.ac.uk/projects/national-review-asthma-deaths (accessed 15 April 2020)

Price DB, Román-Rodríguez M, McQueen RB Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. The Journal of Allergy and Clinical Immunology in Practice. 2017; 5:(4)1071-1081.e9 https://doi.org/10.1016/j.jaip.2017.01.004

Sanchis J, Gich I, Pedersen S Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time?. Chest. 2016; 150:(2)394-406 https://doi.org/10.1016/j.chest.2016.03.041

Inhaler choices for children and adults – do you know all the options. 2017a. https://www.guidelinesfornurses.co.uk (accessed 15 April 2020)

Are all inhalers the same?. 2017b. http://www.letstalkrespiratory.com (accessed 15 April 2020)

Scullion J, Holmes S. Maximizing the benefits of inhaled therapy. Practice Nursing. 2013; 24:(12)594-600 https://doi.org/10.12968/pnur.2013.24.12.594

UK Inhaler Group. UKIG Inhaler Standards and Competency Document. 2019. httpa://ukiginhalerstandards.educationforhealth.org (accessed 15 April 2020)

Respiratory

Teaching inhaler technique

02 May 2020
Clinical Focus
02 May 2020
Volume 2 · Issue 5

Abstract

Inhalers were developed to deliver required medications directly to the lungs whilst minimising any side effects. They are the key to managing exacerbations and symptoms in both asthma and chronic obstructive pulmonary disease but are not yet proven to prevent mortality in the later. Disappointingly, the evidence still shows that many healthcare professionals cannot use them and therefore cannot correctly instruct patients in their use, and that patients are still unable to maximise the benefits they could get from their inhalers because of poor technique and adherence. The following article discusses the issues and offers a simple approach and practical advice on teaching inhaler techniques. It concludes that maybe it is time for us to think differently to teach inhaler technique and use effectively.

The biggest issue faced within teaching inhaler technique is the continued morbidity and mortality for those using inhalers incorrectly and the contribution this makes to the increased use of healthcare resources. This is partly due to inadequate teaching of the correct inhaler usage and promotion of adherence (Price at al, 2017; Al-Jahdali et al, 2013). Another issue healthcare professionals face is the complexity of the number of devices available to prescribe and teach patients. It is estimated that there are over 20 devices with around 116 combinations of drug, device and dose, and this could be as many as 130 if the different pack sizes and refills available are included. Inhalers come in a range of colours and differ in their attributes such as dose counters, ease of use, internal resistance, handling and loading, making it challenging to stay abreast of all the devices.

Register now to continue reading

Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month

Register
Or continue by

Signing in with your registered email address

Inhalers
devices
issues
VARK
IC
adherence