Poor inhaler technique and irregular use are the commonest reasons asthma and COPD appear uncontrolled. Before adding a drug or referring for a biologic, watch the patient use their own device, check prescription refill records and ask how often they actually take it.
Many patients make critical errors with metered-dose inhalers, such as poor coordination or inhaling too fast. A spacer, a switch to a device that suits the patient's inspiratory effort, or a single-inhaler regimen often does more than a new drug.
- Watch the patient use their own inhaler at every review.
- Check refill records against the prescribed dose.
- Offer a spacer to patients who cannot coordinate a metered-dose inhaler.
- Correct technique and adherence before stepping up or referring for biologics.
Why it matters
Escalating treatment for poor technique adds cost and side effects without control.
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