Poor inhaler technique is one of the commonest reasons asthma and COPD stay uncontrolled, and many patients who seem to need more treatment are simply not getting the drug into their lungs. Errors are frequent with every device type.
Watching the patient use their own inhaler, rather than asking, is the quickest check. Metered-dose inhalers work better with a spacer, especially in children, older adults and during exacerbations. Dry powder inhalers need a fast, deep breath that some patients cannot manage. Re-checking at each visit matters, because technique drifts over time.
- Watch the patient use their inhaler at every review before increasing treatment.
- Add a spacer to metered-dose inhalers, especially for children and older adults.
- Match the device to the patient's inspiratory effort and dexterity.
- Check adherence alongside technique before considering a biologic.
Why it matters
Many apparent treatment failures are device failures.
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