Poor inhaler technique is one of the commonest reasons asthma and COPD appear uncontrolled. Before adding a drug or increasing a dose, ask the patient to show you how they use their inhaler, and check adherence with prescription records.
Common errors include not breathing out before inhaling, poor coordination with pressurised metered-dose inhalers, and too weak an inspiration for dry-powder devices. A spacer solves many metered-dose problems. Recheck technique at every review, because it drifts over time.
- Watch the patient use their inhaler before escalating treatment.
- Check refill records to assess adherence.
- Offer a spacer with metered-dose inhalers when coordination is poor.
- Match the device to the patient's inspiratory effort and dexterity.
Why it matters
Escalating a drug that is not reaching the lungs adds cost and side effects without benefit.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for pulmonology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free