Evaluation and importance of different types of inhaler device in patients with chronic obstructive lung disease

Inhaled medications are used in chronic airway disease including chronic obstructive pulmonary disease (COPD) and give the opportunity of low doses, lower side effects, and fast effectiveness. Inhaler devices are frequently used incorrectly by patients. Today, it is generally accepted that poor device use is one of the reasons for poor disease control and low adherence. The aim of the study was to investigate a sample of patients with COPD prescribed with inhaled medication and to evaluate the frequency and pattern of incorrect inhaler use as well as affecting factors.

One hundred and eighty consecutive patients who attended the outpatient clinic with the diagnosis of COPD and were prescribed and receiving different types of inhaler drugs at least for one month were included. The patient's ability to use the devices according to steps was scored face to face after they had replied a questionnaire consisting of 26 questions about their inhaler training and disease specifications. The parameters that may affect incorrect use, pattern of incorrect use, characteristics of the patients who experienced incorrect use, and impact of training were evaluated. Chi-Square and Fisher's Exact test were used for statistical analysis.

The rate of correct use including all steps was 26.3% for metered-dose inhaler (pressurized MDI), 30.4% for inhalation capsule aerolizer, 40.5% for diskus, and 46.3% for turbuhaler. The parameters affecting correct use and number of critical errors causing insufficient drug inhalation were type and duration of initial training due to inhaler devices and also duration and stage of the disease.

COPD patients who were prescribed an inhaler drug should be regularly checked and re-trained during out-patient visits on how to use the inhaler device correctly step by step.