Checking Inhaler Technique in the Community Pharmacy: Predictors of Critical Errors

Area of Science:

• Pharmaceutical Sciences
• Respiratory Medicine
• Patient Care

Background:

• Inhaled medications are essential for respiratory conditions.
• Most patients exhibit critical errors in inhaler technique.
• Community pharmacists are well-positioned to address this care gap.

Purpose of the Study:

• Determine the rate and types of critical inhaler errors in community pharmacies.
• Identify factors contributing to inhaler technique errors.
• Assess when community pharmacists check inhaler use.

Main Methods:

• Fourth-year pharmacy students observed 200 patients in community practice settings.
• Inhaler technique demonstrations were assessed for critical errors.
• Statistical analysis identified predictors of errors and pharmacist checking behaviors.

Main Results:

• 78% of patients demonstrated at least one critical inhaler error.
• High error rates were observed for metered dose inhaler (MDI), Ellipta®, and Discus® devices.
• Key predictors of errors included multiple inhaler possession, rescue inhaler use, and poor asthma control.
• Pharmacists primarily checked technique upon patient request (93%) and for new inhalers (79%).

Conclusions:

• Critical inhaler errors are prevalent in community pharmacy settings.
• Specific inhaler types and patient factors are associated with higher error rates.
• Pharmacist intervention for inhaler technique is often reactive rather than proactive.