This site is intended for health professionals only
Optimal inhaler technique is important to reduce oropharyngeal deposits of inhaled medication and ensure maximal lung deposition. This is further improved by use of a spacer device with metered dose inhalers (MDI).
Patients should have a secure respiratory diagnosis before escalating therapy to ensure the treatment is appropriate for the disease and severity. Patients may have been started on treatment, for instance, if asthma is suspected, but this should be verified by spirometry (lung function tests undertaken by a healthcare professional who has accreditation from the Association for Respiratory Technology and Physiology) as well as a thorough patient history of symptoms (including exacerbations) and physical examination to confirm diagnosis.
Additionally, brand name, rather than generic prescribing2 is encouraged to prevent accidental device switching; it is also good practice to maintain patients on similar devices where possible, to ensure consistency and adherence to therapy.
Inhaler technique (‘check and correct’) can be undertaken by any healthcare professional who has had suitable training and is competent to do so2,3,4 and should be checked at treatment initiation and as part of regular review.5 The UK inhaler group has produced a standards and competency framework document3 for patients and HCPs, which is an excellent educational tool to use with patients when checking and correcting inhaler technique.
The 2014 National Review of Asthma Deaths (NRAD) identified basic failures in care for inhaled therapy. These were failures:
This report highlights the importance of the check on inhaler technique, prescribing and usage, yet the 2016 study1 (two years after NRAD) suggests a current significant problem with patients being unable to use their inhalers. Pharmacists play a vital role in addressing these issues.
Community pharmacists undertaking a consultation as part of a new medicines service (NMS) or medicines use review (MUR) are well placed to check and correct inhaler technique. They can further be assisted by resources such as suggested questions produced by the British Lung Foundation (BLF).6
Author: Ravijyot Saggu