[Analysis of causes of incorrect use of dose aerosols]

Preparations administered by inhalation make relatively high demands on the skill and knowledge of the patient in handling this form of application, for the effectivity of the therapy is inseparably linked to its faultless application. The present article aims at analysing possible mistakes in handling and at finding the most effective way of avoiding them. Several groups of patients with different previous knowledge were analysed in respect of handling skill and the influence of training on an improvement of the same; the patients' self-assessment was analysed by questioning them. Most mistakes are committed by patients whose only information consists of the contents of the package circular. Written instructions alone cannot convey sufficient information especially on how to synchronize the release operations. Major mistakes are insufficient expiration before application in 85.6% of the patients and lack of synchronisation in 55.9%, while the lowest rate of errors in respect of handling was seen in patients who had undergone training and instruction. Training in application associated with demonstration and subsequent exercise reduces the error ratio to a tolerable level. Pulverizers free from propelling gas and preparations applied by means of a spacer are clearly superior to others in respect of a comparatively low error rate. 99.3% of all patients believe they are correctly following the instructions, but on going into the question more deeply it becomes apparent that 37.1% of them make incorrect statements. Hence, practical training in application should get top priority in the treatment of obstructive diseases of the airways. The individual steps of inhalation technique must be explained in detail and demonstrated by means of a placebo dosage aerosol.(ABSTRACT TRUNCATED AT 250 WORDS)