[Poor technique in the use of inhalation drugs by patients with chronic bronchitis/pulmonary emphysema]

To describe errors in inhaler technique of patients with chronic obstructive pulmonary disease (COPD).

Outpatient clinic, Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.

Descriptive.

Adult COPD patients who already used an inhaler were asked to demonstrate their inhaler technique. Using a inhaler-specific checklist errors were registered. A division was made into good, adequate and inadequate technique. For each inhaler a selection of critical actions with regard to effective inhaler technique was made.

Inhaler technique was assessed in 123 COPD patients. Over one-third of all patients had a very poor inhaler technique, which probably resulted in little or even no drug deposition at all. 42% of the patients performed all essential inhaler actions correctly. For patients with a Diskhaler this was 86%, significantly higher than for the other inhalers, Rotahaler and Turbuhaler, which did not differ much (35% and 46%). Poor inhalation technique leads to insufficient bronchodilating or prophylactic effect, to the prescription of more or additional medication with a higher probability of side effects, and to increased costs.

The inhalation technique can be improved substantially with a good instruction protocol.