[Do our asthma patients still use inhalers incorrectly?]

Abstract

Aim: To determine how skilled our patients with asthma are in performing different steps in the use of different inhalation devices, and to identify variables that may influence correct inhalation technique (IT).

Design: Descriptive, cross-sectional study.

Setting: An urban primary care center.

Participants: 141 patients with asthma.

Main outcome measures: Performance of a practical test to evaluate each step in IT for different devices according to SEPAR-semFYC guidelines. One point was scored for each step that was performed correctly, and the technique was considered correct if the total score was >9. The main outcome variable was the percentage of patients who performed the IT correctly.

Results: About three-fourths of the participants (77.3%) were women; mean age was 56.08 +/- 18.99 years. Inhalation technique was incorrect in 53.9% of the patients (51.06% of those who used a pressurized canister inhaler, 59.1% of those who used a PCI+spacer, 38.5% of those who used a Turbuhaler, and 37.5% of those who used an Accuhaler). The highest error rates were seen in exhaling completely before beginning the inhalation (63.78%), holding the breath after inhalation for as long as possible (65.94%), and breathing out slowly after the inhalation (64.86%). Better IT was seen in younger patients with higher levels of education (P=.007). There were no statistically significant differences in the rest of the variables.

Conclusions: A large percentage of patients performed inhalations incorrectly. We cannot conclude that any given device is superior. The variables related with correct IT were age and level of education. Greater health education efforts are needed to teach patients how to use inhalation systems correctly.