Poor technique a problem with new inhalers
Newer dry powder inhalers are ineptly used as often as older pressurised metered dose inhalers, a new study suggests (Annals
of Allergy, Asthma and Immunology 2004;93:439).
Researchers found that 22.8 per cent of patients using dry powder inhalers
(DPIs) and 23.9 per cent of patients using pressurised metered dose inhalers
(pMDIs) failed to perform at least one step judged to be critical for
reliable drug delivery to the lungs.
DPIs were developed in response to the problems that many patients have
in achieving a good inhalation technique with pMDIs and, in controlled
clinical trials under strict conditions, poor inhalation technique has
not been found to be a major problem with DPIs.
However, it is not clear whether, in clinical practice, patients use
DPIs any better than they do pMDIs. The researchers therefore studied
inhalation technique in 1,404 patients aged 15 to 88 years who were experienced
inhaler users. Trained observers recorded
patients’ inhalation techniques using a standardised check-list.
Judith Green, senior respiratory pharmacist at Wirral Hospital NHS Trust,
commented: “Pharmacists can play a pivotal role in asthma and chronic
obstructive pulmonary disorder management. We are ideally placed to assess
patients’ ability to use inhaler devices and to ensure therapy
is optimised.”
She added: “Patient preference and ability to use the device are
crucial to successful management. Dry powder inhalers are good inhaler
devices if used appropriately. The
patients’ inspiratory flow rate and manual dexterity must be considered
before prescribing such devices.” |
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