MISUSE OF PRESSURIZED METERED-DOSE INHALERS BY ASTHMATIC-PATIENTS TREATED IN FRENCH PRIVATE-PRACTICE

Although metered dose inhalers (MDIs) are widely used to treat asthma, clinical studies suggest that misuse is frequent. We studied the freq uency of, and factors related to, misuse of MDIs in asthmatic patients of French private practice. 264 chest specialists or general practiti oners completed questionnaires including characteristics of patients a nd asthma, technique in using inhalers and previous instruction, for t hree consecutive asthmatics aged > 6 years and currently using MDIs: 6 68 adults (mean age 47.8 years +/- 18.5, 51.8 % males) and 100 childre n (mean age 11.5 years +/- 2.1, 72.0 % males) were included. Adequate technique (deep inspiration synchronized with inhaler activation, foll owed by holding breath for 5 seconds) was used by 33.2 % of adults and 26.0 % of children; optimal technique (same, plus shaking the inhaler before use and activating it only once) was used by 22.1 % of adults and 20.0 % of children. The main factor related to misuse of MDIs was absence of previous instruction. However only 26.5 % of instructed adu lts and 22.1 % of instructed children used the optimal technique. Misu se of MDIs is a public health problem and instruction is unlikely to s olve it. The use of different types of devices, like dry powder breath -actuated inhalers should be encouraged.