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How patients determine when to replace their metered-dose inhalers
R A Ogren1, J L Baldwin, R A Simon
1Division of Allergy/Immunology, Scripps Clinic and Research Foundation, La Jolla, California, USA.
Summary
Many asthma patients overuse metered-dose inhalers (MDIs) past their recommended limit, unaware of the risks. This practice, driven by poor knowledge and replacement habits, may contribute to increased asthma morbidity and mortality.
Area of Science:
- Pulmonary Medicine
- Pharmacology
- Patient Adherence
Background:
- Rising asthma morbidity and mortality in the US may be linked to metered-dose inhaler (MDI) overuse.
- Patients may continue using inhaler canisters beyond the manufacturer's specified maximum number of actuations.
Purpose of the Study:
- To assess patient awareness of inhaler actuation limits.
- To investigate patient methods for determining inhaler replacement.
- To evaluate actual inhaler contents beyond stated limits.
Main Methods:
- Surveyed patients on MDI usage, awareness of actuation limits, and replacement practices.
- Determined excess actuations in inhalers post-maximum limit.
- Assessed inhaler flotation status after exceeding the specified number of actuations.
Main Results:
- 54% of patients were unaware of the manufacturer's maximum actuation limit.
- Only 8% of patients tracked inhaler actuations.
- All tested inhalers contained more actuations than listed; flotation was not a reliable indicator of the maximum limit.
Conclusions:
- Lack of patient knowledge and current replacement practices lead to MDI overuse beyond recommended limits.
- Extending MDI use past the specified maximum actuations may contribute to increased asthma-related health issues.
- Improved patient education and adherence to MDI guidelines are crucial for managing asthma.