Evaluating the technique of using inhalation device in COPD and bronchial asthma patients

Respir Med. 2014 Jul;108(7):992-8. doi: 10.1016/j.rmed.2014.04.021. Epub 2014 May 14.


Background: In asthma management, poor handling of inhalation devices and wrong inhalation technique are associated with decreased medication delivery and poor disease control. The key to overcome the drawbacks in inhalation technique is to make patients familiar with issues related to correct use and performance of these medical devices. The objective of this study was to evaluate and analyse technique of use of the inhalation device used by patients of COPD and Bronchial Asthma.

Methods: A total of 300 cases of BA or COPD patients using different types of inhalation devices were included in this observational study. Data were captured using a proforma and were analysed using SPSS version 15.0.

Result: Out of total 300 enrolled patients, 247 (82.3%) made at least one error. Maximum errors observed in subjects using MDI (94.3%), followed by DPI (82.3%), MDI with Spacer (78%) while Nebulizer users (70%) made least number of errors (p = 0.005). Illiterate patients showed 95.2% error while post-graduate and professionals showed 33.3%. This difference was statistically significant (p < 0.001). Self-educated patients committed 100% error, while those trained by a doctor made 56.3% error.

Conclusion: Majority of patients using inhalation devices made errors while using the device. Proper education to patients on correct usage may not only improve control of the symptoms of the disease but might also allow dose reduction in long term.

Keywords: Bronchial Asthma; COPD; DPIs; MDIs; Nebulizer; Spacers.

Publication types

  • Evaluation Study
  • Observational Study

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Asthma / drug therapy*
  • Equipment Design
  • Female
  • Humans
  • Male
  • Medication Errors
  • Metered Dose Inhalers
  • Middle Aged
  • Nebulizers and Vaporizers*
  • Patient Compliance
  • Patient Education as Topic / methods
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Respiratory System Agents / administration & dosage*
  • Respiratory System Agents / therapeutic use
  • Self Administration / methods
  • Self Administration / standards
  • Social Class
  • Young Adult


  • Respiratory System Agents