Assessment of the Inhaler Handling Technique In Patients With Chronic Obstructive Pulmonary Disease In A Chest Clinic

Improper handling of inhaler devices can result in errors that affect drug delivery to the lungs and ultimately influence disease outcomes. This study assessed inhaler techniques and risk factors for critical errors in COPD patients at a tertiary chest clinic in Nigeria.

Spirometry-confirmed COPD patients were evaluated using a standardized inhaler technique checklist. Demographic and clinical data were collected. Inhaler use was classified as correct/no error, non-critical errors, or critical errors.

Eighty patients participated, with 49 (61.3%) being males. All participants used pressurized metered dose inhalers (pMDI), and 70 (87.5%) used dry powder inhalers (DPI). Correct inhaler technique was observed in 7.5% of pMDI users, significantly lower than the 20% among DPI users (p = 0.025). Critical and non-critical errors occurred in 62.5% and 77.5% of pMDI users, and 68.6% and 65.7% of DPI users, respectively. The most common critical error among pMDI users was failure to actuate during deep slow inhalation, while among DPI users it was failure to exhale fully before inhalation. Self-reported inhaler dissatisfaction predicted critical errors among pMDI users. Among DPI users, predictors included female sex, lack of recent inhaler technique training, and lower inhaler satisfaction.

Critical inhaler technique errors are highly prevalent among COPD patients in this setting, particularly among pMDI users. Factors such as inhaler dissatisfaction, female sex, and lack of recent inhaler training increase the risk of errors. These findings highlight the need for regular assessment of inhaler technique and personalized patient education to optimize device use and improve outcomes.