Poor inhaler technique and low adherence are among the commonest reasons asthma and COPD appear uncontrolled. Before adding a drug or switching to a biologic, ask the patient to show you how they use their device, correct errors, and ask about how often they actually take it.
Most errors are fixable in a minute: not exhaling first, not sealing the lips, poor coordination with a pressurised inhaler, or inhaling too gently through a dry-powder device. A spacer helps many pressurised-inhaler users.
- Ask the patient to demonstrate their inhaler at every review
- Correct technique before increasing treatment
- Ask about adherence in a non-judgemental way
- Offer a spacer with pressurised inhalers where coordination is poor
Why it matters
Many patients labelled difficult-to-treat are not taking in the drug they already have.
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