A review of the metered dose inhaler technique in asthmatic and COPD patients

Abstract

To assess the pressurised metered dose inhaler (pMDI) technique using a large volume spacer (LVS) in asthma and Chronic Obstructive Pulmonary Disease (COPD) patients who were admitted in medical wards or attending the outpatient clinic. Asthma or COPD patients were randomly recruited over an eight-month period from the wards and outpatients clinics at Mater Dei Hospital. Only patients using the pMDI were included. Data was collected using a questionnaire filled in by an interviewer who also assessed the inhaler technique using a checklist of 8 steps necessary for appropriate pMDI use. A total of 174 patients, 118 (67.4%) of which are asthmatics while 56 (32%) are COPD patients, were involved. A total score of 8 was achieved by 21 of the asthma patients and 3 of the COPD patients. 154 (88%) of all the patients owned a LVS but only 100 (57.5%) of all the patients used the LVS with pMDI regularly. This study shows that despite the fact that it is a well-known fact that appropriate drug delivery is key to controlling Asthma and COPD, patients still tend to have poor pMDI technique hence the need for patient education with repeated assessment of the technique in follow-up clinics and prior to discharge.