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The ADMIT series – Issues in Inhalation Therapy. 2) Improving technique and clinical effectiveness

Prim Care Respir J 2009 June;18(2): 76-82

Broeders et al. 2009

* Mariëlle EAC Broedersa, Joaquin Sanchisb, Mark L Levyc, Graham K Cromptond, PN Richard Dekhuijzena, on behalf of the ADMIT Working Groupe

a Dept. of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, The Netherlands

b Departament de Pneumologia, Hospital de la Santa, Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Spain

c Senior Clinical Research Fellow, Allergy & Respiratory Research Group, Division of Community Health Sciences: GP Section, University of Edinburgh, Scotland, UK

d Western General Hospital, Edinburgh, UK

e Members of the Aerosol Drug Management Improvement Team (ADMIT): Peter J Barnes, London, UK; Mariëlle Broeders, Nijmegen, The Netherlands; Chris Corrigan, London, UK; Graham K Crompton, Edinburgh, UK; Lorenzo Corbetta, Firenze, Italy; Richard Dekhuijzen, Nijmegen, The Netherlands; Jean Christophe Dubus, Marseille, France; Thomas Hausen, Essen, Germany; Meinhard Kneussl, Vienna, Austria; Federico Lavorini, Firenze, Italy; Mark L Levy, Edinburgh, UK; Soren Pedersen, Kolding, Denmark; Antonio Ramalho de Almeida, Porto, Portugal; Joaquin Sanchis, Barcelona, Spain; Jose L. Viejo, Hospital General Yagüe de Burgos, Spain; Walter Vincken, Brussels, Belgium; Thomas Voshaar, Moers, Germany

Received 26 February 2008 • Accepted 6 February 2009 • Online 27 May 2009

Abstract
Aerosol inhalation is considered the optimal route for administering the majority of drugs for the treatment of obstructive airways diseases. A number of Pressurised Metered-Dose and Dry Powder Inhalers are available for this purpose. However, inhalation of therapeutic aerosols is not without difficulty; it requires precise instructions on the inhalation manoeuvre, which is different from spontaneous normal breathing. Also, the characteristics of the inhaler device have to be suitable for the user. Available data indicate a frequent lack of knowledge demonstrated by health professionals and patients on the inhalation manoeuvre and handling of inhalers, resulting in a reduction of therapeutic benefit. This paper reviews the literature concerning the fundamental aspects of inhaler devices, inhalation manoeuvre and device selection, in an attempt to increase the knowledge of, and to optimise the clinical use of, therapeutic inhalers.

Keywords
Inhalers, inhalation technique, aerosol therapy, pMDI, dry powder inhalers

Corresponding author.* Mariëlle EAC Broeders Tel: +31-24-3614579 Fax: +31-24-3610324 Email: m.broeders@long.umcn.nl

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