Abstract
Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre, cross-sectional, observational study investigates the prevalence of inhaler mishandling in a large population of experienced patients referring to chest clinics; to analyze the variables associated with misuse and the relationship between inhaler handling and health-care resources use and disease control. We enrolled 1664 adult subjects (mean age 62 years) affected mostly by COPD (52%) and asthma (42%). Respectively, 843 and 1113 patients were using MDIs and DPIs at home; of the latter, the users of Aerolizer ®, Diskus®, HandiHaler® and Turbuhaler® were 82, 467, 505 and 361. We have a total of 2288 records of inhaler technique. Critical mistakes were widely distributed among users of all the inhalers, ranging from 12% for MDIs, 35% for Diskus ® and HandiHaler® and 44% for Turbuhaler ®. Independently of the inhaler, we found the strongest association between inhaler misuse and older age (p = 0.008), lower schooling (p = 0.001) and lack of instruction received for inhaler technique by health caregivers (p <0.001). Inhaler misuse was associated with increased risk of hospitalization (p = 0.001), emergency room visits (p <0.001), courses of oral steroids (p <0.001) and antimicrobials (p <0.001) and poor disease control evaluated as an ACT score for the asthmatics (p <0.0001) and the whole population (p <0.0001). We conclude that inhaler mishandling continues to be common in experienced outpatients referring to chest clinics and associated with increased unscheduled health-care resource use and poor clinical control. Instruction by health caregivers is the only modifiable factor useful for reducing inhaler mishandling.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 930-938 |
| Number of pages | 9 |
| Journal | Respiratory Medicine |
| Volume | 105 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2011 |
| Externally published | Yes |
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Keywords
- Asthma
- COPD
- DPI
- Inhaler technique
- MDI
- Patient education
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Inhaler mishandling remains common in real life and is associated with reduced disease control. / Melani, Andrea S.; Bonavia, Marco; Cilenti, Vincenzo; Cinti, Cristina; Lodi, Marco; Martucci, Paola; Serra, Maria; Scichilone, Nicola; Sestini, Piersante; Aliani, Maria; Neri, Margherita.
In: Respiratory Medicine, Vol. 105, No. 6, 06.2011, p. 930-938.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Inhaler mishandling remains common in real life and is associated with reduced disease control
AU - Melani, Andrea S.
AU - Bonavia, Marco
AU - Cilenti, Vincenzo
AU - Cinti, Cristina
AU - Lodi, Marco
AU - Martucci, Paola
AU - Serra, Maria
AU - Scichilone, Nicola
AU - Sestini, Piersante
AU - Aliani, Maria
AU - Neri, Margherita
PY - 2011/6
Y1 - 2011/6
N2 - Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre, cross-sectional, observational study investigates the prevalence of inhaler mishandling in a large population of experienced patients referring to chest clinics; to analyze the variables associated with misuse and the relationship between inhaler handling and health-care resources use and disease control. We enrolled 1664 adult subjects (mean age 62 years) affected mostly by COPD (52%) and asthma (42%). Respectively, 843 and 1113 patients were using MDIs and DPIs at home; of the latter, the users of Aerolizer ®, Diskus®, HandiHaler® and Turbuhaler® were 82, 467, 505 and 361. We have a total of 2288 records of inhaler technique. Critical mistakes were widely distributed among users of all the inhalers, ranging from 12% for MDIs, 35% for Diskus ® and HandiHaler® and 44% for Turbuhaler ®. Independently of the inhaler, we found the strongest association between inhaler misuse and older age (p = 0.008), lower schooling (p = 0.001) and lack of instruction received for inhaler technique by health caregivers (p <0.001). Inhaler misuse was associated with increased risk of hospitalization (p = 0.001), emergency room visits (p <0.001), courses of oral steroids (p <0.001) and antimicrobials (p <0.001) and poor disease control evaluated as an ACT score for the asthmatics (p <0.0001) and the whole population (p <0.0001). We conclude that inhaler mishandling continues to be common in experienced outpatients referring to chest clinics and associated with increased unscheduled health-care resource use and poor clinical control. Instruction by health caregivers is the only modifiable factor useful for reducing inhaler mishandling.
AB - Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre, cross-sectional, observational study investigates the prevalence of inhaler mishandling in a large population of experienced patients referring to chest clinics; to analyze the variables associated with misuse and the relationship between inhaler handling and health-care resources use and disease control. We enrolled 1664 adult subjects (mean age 62 years) affected mostly by COPD (52%) and asthma (42%). Respectively, 843 and 1113 patients were using MDIs and DPIs at home; of the latter, the users of Aerolizer ®, Diskus®, HandiHaler® and Turbuhaler® were 82, 467, 505 and 361. We have a total of 2288 records of inhaler technique. Critical mistakes were widely distributed among users of all the inhalers, ranging from 12% for MDIs, 35% for Diskus ® and HandiHaler® and 44% for Turbuhaler ®. Independently of the inhaler, we found the strongest association between inhaler misuse and older age (p = 0.008), lower schooling (p = 0.001) and lack of instruction received for inhaler technique by health caregivers (p <0.001). Inhaler misuse was associated with increased risk of hospitalization (p = 0.001), emergency room visits (p <0.001), courses of oral steroids (p <0.001) and antimicrobials (p <0.001) and poor disease control evaluated as an ACT score for the asthmatics (p <0.0001) and the whole population (p <0.0001). We conclude that inhaler mishandling continues to be common in experienced outpatients referring to chest clinics and associated with increased unscheduled health-care resource use and poor clinical control. Instruction by health caregivers is the only modifiable factor useful for reducing inhaler mishandling.
KW - Asthma
KW - COPD
KW - DPI
KW - Inhaler technique
KW - MDI
KW - Patient education
UR - http://www.scopus.com/inward/record.url?scp=79955484156&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79955484156&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2011.01.005
DO - 10.1016/j.rmed.2011.01.005
M3 - Article
C2 - 21367593
AN - SCOPUS:79955484156
VL - 105
SP - 930
EP - 938
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
IS - 6
ER -