The effectiveness of inhalers in coping with COPD and asthma in adults is affected by numerous factors among them the adherence to inhaled corticosteroids particularly MDI and DPI. Studies done by different researchers show consistent results in regards to the outcomes of the therapy depending on the choice of the type of inhaler and the adherence level each patient record. The type of treatment delivery used is not a major factor that influences the outcome of the treatment, but it is the patient’s adherence to the treatment (2). A study to determine whether patients show the same adherence to a treatment found out that patients have a huge claim in determining whether or not there will be a positive outcome from the treatment they are given. It is therefore, important according to the study, to include patients in the choice of the inhaler inhalers (5). According to the studies patients can improve their adherence to the treatments is they belief that the treatment is effective. In the same sense, the study showed that there is no significant difference in the adherence levels among patients in regards to the type of inhalers used. Reviews from previous studies show that patients do not record any difference when they use dry powder inhalers or MDI (4).
In other studies to determine how incorrect use of DPI affects the outcomes of a treatment, it was found that the patients do not use the DPIs as prescribed hence they record negative outcomes. This means that patients who are not in a position to generate enough inspiratory airflow are in a higher risk of poor inhaler technique management. This was the same result found by the research on inhaler mishandling which recorded that 27% of patients who chose to use MDI handled it inappropriately (3). Getting the correct amount of the inhalant into one’s system is the main problem as patients always have a problem inhaling and getting the right amount of the substance into their lungs. This proves that there are many cases where patients are not in a good position to handle and use their inhalers well no matter the type of inhaler they choose. This can be attributed to lack of education as proven by the research that show patients do not receive any form of education or training on how to use the device given appropriately (1).
Identifying the different factors that contribute to the inappropriate use of inhalers may help in identifying how to improve its use and record positive outcomes among the patients. Having an idea of how the inhaler works and educating the patients may contribute to a more positive outcome than when the patients and the person prescribing the inhaler do not have sufficient information regarding the usage of the inhaler (6). The studies conducted on how to use the inhalers show that patients using dry inhalers especially the Aerolizer recorded fewer mistakes as compared to those using the HandiHaler or Turbuhaler. The study shows that the need to have manufacturers of the inhalers come out and take part in the publicity of their product in collaboration with health officials can go a long way in helping eliminate the misuse of their products and increase efficiency in the use of inhalers among patients with asthma and COPD. Hospitalized patients are recorded to be the highest among those misusing the inhalers hence more education is needed to train their health providers of how to handle the devices well (7).
References
- Chrystyn, H. (2005). Do patients show the same level of adherence with all dry powder inhalers? Bradford: Blackwell Publishing Ltd.
- Gustafsson, P., Taylor, A., Zanen, P.,&Chrystyn, H.(2005).Can patients use all dry powder inhalers equally well? New York: Blackwell Publishing Ltd.
- Lavorini, F. et al. Effect of incorrect use of dry powder inhalers onmanagement of patients with asthma and COPD.
- Melani, A. S. et al. (2011). Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine (2011) 105, 930e938.
- Press, V.G. et al.(2011).Misuse of Respiratory Inhalers in Hospitalized Patients with Asthma or COPD.Press et al. Society of General Internal Medicine. J Gen Intern Med 26(6):635–42.
- Roy, A., Battle, K., Lurslurchachai, L., Halm, L. A. &Wisnivesky, J. P. (2011).Inhaler device, administration technique, and adherence toinhaled corticosteroids in patients with asthma. Prim Care Respir J 2011; 20(2): 148-154.
- Wieshammer, S.,&Dreyhaupt, J. (2008).Dry Powder Inhalers: Which Factors
Determine the Frequency of HandlingErrors?Respiration 2008;75:18–25.