Inhaler Technique for People with Asthma or COPD

Incorrect technique when taking inhaled medications frequently prevents patients with asthma or chronic obstructive pulmonary disease (COPD) from receiving the maximal benefit from their medications.

Key points

• Most patients with asthma or COPD do not use their inhalers properly, and most have not had their technique checked or corrected by a health professional
• Incorrect inhaler technique when using maintenance treatments increases the risk of severe flare-ups and hospitalisation for people with asthma or COPD
• Poor asthma symptom control is often due to incorrect inhaler technique
• Incorrect inhaler technique when using inhaled corticosteroids increases the risk of side-effects like dysphonia and oral thrush
• The steps for using an inhaler device correctly differ between brands
• Checking and correcting inhaler technique can improve asthma outcomes.

Recommendations

• Make sure the inhaler is appropriate for the patient's age, developmental stage and dexterity
• Assess inhaler technique at every opportunity, even for patients who have been using the inhaler for many years
• Provide all patients with individualised, hands-on training in correct inhaler use: explain and then demonstrate
• Repeat assessment and training regularly
• To assess technique, ask the person to show you how they use their inhaler, and check against the correct checklist for that type of inhaler. Provide the checklist as a reminder, and write down or highlight any steps that were done incorrectly (e.g. on a sticker attached to their inhaler)
• Inhaler technique should always be checked before considering stepping up medication
• Community pharmacists should reinforce correct technique by reassessing technique and repeating the training when dispensing inhalers.

Errata

Page 3: Table 1. Types of inhalers for asthma and COPD medicines

Incorrect pharmacological class stated for Oxis Turbuhaler (formoterol) and Serevent Accuhaler (salmeterol) in 'Dry-powder inhaler (multi-dose)' section. Pharmacological class should state: 'LABA' not 'LAMA'

Page 3: Table 1. Types of inhalers for asthma and COPD medicines

Incorrect pharmacological class stated for Seebri Breezhaler (glycopyrronium) and Spiriva Handihaler (tiotropium) in 'Dry-powder inhaler (capsule)' section. Pharmacological class should state: 'LAMA' not 'LABA'

The PDF version has been amended.

Acknowledgements

This information paper was prepared in consultation with the following health professionals:

• Professor Sinthia Bosnic-Anticevich, pharmacist
• Dr Tim Foo, general practitioner
• Professor Helen Reddel, respiratory physician
• Ms Judi Wicking, asthma and respiratory educator

This update was funded by a grant from Teva Pharma Australia. Apart from providing a financial grant, Teva has not been involved in the development, recommendation, review or editing of this publication. The original version was developed with support from the Australian Government Department of Health.

Recommended citation

National Asthma Council Australia. Inhaler technique for people with asthma or COPD. National Asthma Council Australia, Melbourne, 2018.

How-To Video Library

Our library of How-To videos includes clips showing the correct use of various asthma and COPD inhalers. There are also clips showing correct use of allergy nasal sprays. 

Disclaimer

Although all care has been taken, this information paper is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.

© 2018