Check inhaler technique before escalating therapy

A large share of patients use their inhaler incorrectly, and poor technique looks exactly like treatment failure — which tempts a step-up when the real problem is delivery.

Watch the patient actually use their own device at each visit and correct the specific error, rather than assuming competence. Before escalating therapy for apparently uncontrolled asthma or COPD, rule out poor technique and poor adherence, and match the device to what the patient can reliably manage — a spacer with a metered-dose inhaler, or a different device altogether.

• Watch the patient use their own inhaler at each visit rather than assuming correct technique.
• Before stepping up therapy for uncontrolled disease, rule out poor technique and adherence.
• Match the device to the patient's ability — add a spacer or switch device where needed.
• Re-check technique whenever control slips or the device changes.

Why it matters

Poor inhaler technique mimics treatment failure, so escalating drugs without checking it wastes medication and misses the real problem.

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