Inhalation systems | Ideal device | Practical Aspects | Instruction

Need for instruction of patients and professionals

In numerous studies it has become obvious that the correct use of an inhalation device is critical for effective treatment. Therefore patients have to be instructed thoroughly how to use their device. Prerequisite for successful instruction is that the prescribing authorities themselves are well-informed and familiar with issues concerning performance and correct use.

As early as 30 years ago, several studies already demonstrated deficiencies in patients and health care professionals concerning the use of inhalation devices. Despite educational efforts incorrect use of inhaler devices is still frequently observed. In a study including more than 700 patients, 466 nurses and 428 physicians only 9% of patients showed a correct inhalation technique with metered dose inhalers (MDI). Although physicians performed significantly better than nurses (28% vs. 15%) this study showed severe deficiencies regarding the instruction knowledge of professionals.

However high quality instruction on the correct use of inhaler devices leads to significant improvement concerning the inhalation technique. In general group instructions appear to generate better results than personal education. Considerable improvement can also be achieved by video instructions. Since coordination using a MDI is more difficult for the patient normally higher improvement rates are observed regarding inhalation technique of MDIs compared with DPIs.


van der Palen J, Klein JJ, Kerkhoff AH, van Herwaarden CL, Seydel ER. Evaluation of the long-term effectiveness of three instruction modes for inhaling medicines. 1997. Patient Educ Couns; 32 (Suppl. 1): S87-95

Plaza V, Sanchis J. CESEA group. Medical personnel and patient skill in the use of metered dose inhalers: a multicentric study. 1998. Respiration; 65: 195-198

Improvement of inhalation technique in relation to instruction method

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