Effective use of inhalers in Adult patients

I've heard from nurses in practice that incorrect inhaler technique is a real problem for sufferers of Asthma. I'm currently trying to look into this and find some evidence that suggests this is really the case. If anyone has seen any evidence or research to suggest this I would be grateful for any assistance you may be able to offer.

Many thanks.

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M Hindle, DA Newton, and H Chrystyn

Investigations of an optimal inhaler technique with the use of urinary salbutamol excretion as a measure of relative bioavailability to the lung

Thorax, Jun 1993; 48: 607 - 610.

SP Newman, AW Weisz, N Talaee, and SW Clarke

Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique

Thorax, Oct 1991; 46: 712 - 716.

There's a couple of starters for 10; but also remember plain logic comes into it too - poor inhaler technique = poor drug delivery.

When you say ""inhaler technique is a real problem"" what do you mean by ""problem""? A problem in drug delivery, or asthma management, or for the patient?

HTH,

CathBear

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I will throw my 2p's worth into the ring too...

As a Kick Asthma Holiday volunteer, I've seen some VERY random inhaler techniques being employed, most of which were clearly affecting the amount of drug inhaled. To make matters worse, parents have verified that these techniques have been suggested by the child's asthma nurse/GP.

Although my experience is with children, the same would apply to adult patients - especially those newly diagnosed, or newly switched to a different type of inhaler.

So it must also be worth looking at a possible ""root cause"" of bad inhaler technique; namely, being shown how to use them incorrectly in the first place.

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First of all thank you both so much for your comments.

Just to give a bit of background. I am a first year Student Nurse about to commence my first placement in a Respiratory Ward in a local hospital. I'm currently looking into the above question in relation to an evidence based research assignment, but also in relation to learning a bit more about conditions that I may face in my placement, being a Respiratory Ward I guessed that I may see a fair number of patients in that have Asthma.

I would say that in this question I am actually looking at how Asthma is managed, rather than how effective a particular drug is in this instance. It's all still a bit complex for me at this early stage, but just about grasping the basics of some of this research / evidence that is out there.

Again, many thanks.