Inhalation technique of 166 adult asthmatics prior to and following a self-management

Self-management of asthma and self-treatment of exacerbations are considere d important in the treatment of asthma. For successful self-treatment, medi cation has to be inhaled correctly, but the percentage of patients inhaling effectively varies widely. As part of a self-management program we checked and corrected inhalation technique. This paper addresses differences among inhalers in relation to patient characteristics and the effect of instruct ion, 1 year after enrollment. Maneuvers that are essential for adequate inh alation were identified. When errors in inhalation technique were observed, patients were instructed in the correct use of their devices. One year lat er, inhalation technique was checked again. Only patients who used the same inhaler throughout the entire study period were analyzed. Of the 245 adult asthmatic patients who were enrolled in the self-management program, 166 u sed the same inhaler throughout the study period. One hundred twenty patien ts (72%) performed all key items correctly at baseline and this increased t o 80% after 1 year. At followup, older patients were less likely to demonst rate a perfect inhalation. Patients with a Diskhaler(R) made fewest errors. Adjustment for differences in patient characteristics did not significantl y change the results. Because many patients with asthma use their inhaler i neffectively, there is a need to know which inhaler leads to fewest errors. Diskhaler was nominated by this study. When patients are not able to demon strate adequate inhalation technique in a "tranquil" setting, it is doubtfu l that they can do so when they experience an exacerbation. Therefore, inha lation instruction should be considered an essential ingredient, not only o f self-management programs, but also of asthma patient care in general.