A recent study presented to the American College of Chest Physicians found that one in three patients with asthma or chronic obstructive pulmonary disease (COPD) use an inhaler incorrectly. The study’s author said this misuse can lead to serious adverse health effects.

“The frequent misuse of dry powder inhalers can lead to the inappropriate dosage of medication, which can result in increased morbidity and mortality for patients,” Siegfried Wieshammer, MD, said. “Our results suggest that inhaler type, age, severity of lung obstruction, and prior training can determine the risk of inhalation errors. These factors should be considered before prescribing an inhaler for a patient.”

Dr. Wieshammer and his team at the University of Heidelberg in Germany said physicians need to be more careful in the instruction they give patients using inhalers. The four types of dry powder inhalers used in the study included:

• Advair Diskus® manufactured by GlaxoSmithKline;
• Foradil® Aerolizer, manufactured by Novartis;
• Spiriva HandiHaler, manufactured by Pfizer, Inc; and
• Pulmicort Turbohaler®, manufactured by AstraZeneca.

“Matching the appropriate device for an individual patient is as important as selecting the drug to be delivered because the best drug remains ineffective if it is not deposited to the lung,” he said. “Our data suggest that DPIs are useful tools in the management of younger patients with normal lung function or mild airway obstruction provided that instruction in inhalational technique is given by medical personnel.”

Dr. Alvin V. Thomas, Jr., President of the American College of Chest Physicians, offered more explicit advice for healthcare providers.

“Regardless of inhaler type, clinicians should provide instruction on the correct use of inhalers and have patients demonstrate proper usage before leaving the office,” he said.

Source: American College of Chest Physicians, “1 in 3 patients with asthma or COPD misuse inhalers,” October 23, 2007.