Poor inhaler technique is common and is one of the main reasons treatment appears to fail. Before adding a drug, watch the patient use their own device and correct the errors.
Match the device to the patient's inspiratory effort and dexterity: a dry powder inhaler needs a fast, deep breath, while a pressurised metered-dose inhaler with a spacer suits patients who cannot generate one.
- Ask the patient to demonstrate their inhaler at every review.
- Use a spacer with metered-dose inhalers, especially in older patients.
- Choose a device the patient can use rather than switching drugs.
- Keep devices consistent across medicines where possible.
Why it matters
Many apparent treatment failures are technique failures that a new drug will not fix.
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