Siobhan Brophy
Communications Manager, National Asthma Council Australia
Improving patient inhaler technique improves health outcomes
Most of the millions of Australians with chronic obstructive pulmonary disease (COPD) and asthma rely on inhaled medications to manage their conditions. But despite their widespread use, evidence suggests that up to 90% of patients are misusing their inhalers – even the long term patients.1
 Inhaler misuse results in poor medication delivery and reduced lung deposition. These in turn can lead to poorer health outcomes, more frequent and longer hospital stays and an increased dependence on medication.
In light of this problem, the NAC has developed two new educational resources for GPs and patients to help improve patient inhaler technique.
Evidence on inhaler use
‘Inhaler technique in adults with asthma or COPD’, an information paper for health professionals, summarises the evidence base behind the issue while offering practice tips for improving patient technique.1 The paper was written in collaboration with a team of experts including Associate Professor Helen Reddel, a respiratory physician, and GP Dr Gary Kilov.
The paper focuses on the prevalence of poor technique, and how health outcomes can be improved by helping patients use the inhalers correctly. It offers a number of tips on how to address the common errors associated with each of the main types of inhalers.
Recent studies confirm that patients are unlikely to use inhalers correctly unless they receive clear instruction, regardless of the type of inhaler they use, and that the risk of misusing inhalers is particularly high in older and more debilitated patients.1
Ways to help
There are six ways that GPs can help patients use their inhalers correctly1:
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make sure your own knowledge of correct technique is up to date, and that you know the errors commonly made with the different types of inhalers
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ensure the inhaler is appropriate for the patient. Where possible, avoid prescribing multiple inhaler types
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ask patients to show you how they use their inhaler. Most patients don’t know that their technique is incorrect
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give patients verbal instruction – not just a leaflet. The manufacturer’s instructions alone are not sufficient to teach the patient the correct technique
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provide a physical demonstration, either via a video or one-on-one instruction
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repeat instruction regularly. Patients’ technique can deteriorate as soon as 3 months after education.
Inhaler demonstration videos
One of the most effective ways to improve patient technique is via video demonstration. With this in mind, the NAC has developed a new series of web based videos on correct inhaler use.2 The short videos are designed for both health professionals and patients, and allow GPs to check their own skills while also providing them with a reliable online resource that can be confidently recommended to patients.
All five main types of asthma and COPD inhalers currently on the market in Australia are covered in the videos: standard metered dose inhaler (with and without spacer), Autohaler, Accuhaler, Turbuhaler and Handihaler. In each 2 minute video, NAC asthma educator Judi Wicking provides a patient with step-by-step usage instructions for a particular inhaler. To aid comprehension, captions are included.
Access online
These resources are part of the wider ‘Prevent puffer problems’ campaign, an initiative of the Department of Veterans’ Affairs that also includes education components for pharmacists.
To view the inhaler videos, read the information paper or to access a range of asthma resources, visit the NAC website at http://www.nationalasthma.org.au/
References
1. National Asthma Council Australia (NAC). Inhaler technique in adults with asthma or COPD. Melbourne: NAC, 2008. Available at www.nationalasthma.org.au/content/view/594/1028/.
2. National Asthma Council Australia (NAC). Using your inhaler (video). Melbourne: NAC, 2008. Available at www.nationalasthma.org.au/content/view/548/984/.
Acknowledgement
Preventing puffer problems
Originally published in GP Review, March 2009. Reproduced with permission.
Download a PDF of this article from the GP Review website: http://www.racgp.org.au/gpreview/200809/27025
Content Updated March 2009
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