Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique

Chest. 2000 Feb;117(2):542-50. doi: 10.1378/chest.117.2.542.


Background: Patient compliance, inhalation devices, and inhalation techniques influence the effectiveness of inhaled medications.

Methods: This article presents the results of a systematic literature review of studies measuring compliance with inhaled corticosteroids, measuring inhalation technique with different inhalation devices, and estimating the proportion of inhaled drug that is deposited in the lung.

Results: Overall, patients took the recommended doses of inhaled medication on 20 to 73% of days. Frequency of efficient inhalation technique ranged from 46 to 59% of patients. Education programs have been shown to improve compliance and inhalation techniques. The lung deposition achieved with different inhalers depends on particle size as well as inhaler technique.

Conclusion: This review demonstrates that multiple factors may come between a prescription of an inhaled corticosteroid and the arrival of that medicine at its target organ, the lung.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / pharmacokinetics
  • Adult
  • Asthma / blood
  • Asthma / drug therapy*
  • Equipment Design
  • Humans
  • Lung / drug effects
  • Lung / metabolism
  • Nebulizers and Vaporizers*
  • Patient Compliance*
  • Patient Education as Topic
  • Treatment Outcome


  • Adrenal Cortex Hormones