Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease

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Abstract

Aim. Investigate inhalation techniques using different inhalers types and their effect on the course of disease.

Materials and methods. This cross-sectional study included 110 patients with asthma, chronic obstructive pulmonary disease using the inhaler at least one month. Inhaler errors performed during demonstration were evaluated for each patient and entered in the check-lists. We also collected information about co-morbidities, education, mMRC dyspnea score, rate of exacerbations, and performed spirometry.

Results. 80.9% of patients used metered-dose inhaler, 20.9% – single-dose and 21.8% – multiple-dose dry powder inhaler, 22.7% – soft-mist inhaler. Inhaler errors were made by 80.9% patients. The mean number of mistakes in metered-dose inhaler use was 2±1.6, single-dose powder inhaler –1.5±1.3, multiple-dose dry powder inhaler – 1.25±1.4, soft-mist inhaler – 0.68±0.7 (р=0.003). Age, diagnosis, duration of disease, education level, inhalers usage by relatives have no influence on the inhalation technique. A number of errors was related to female gender (р=0.007) and usage of more than 2 inhalers (r=0.3, p=0.002), previous instruction about inhalation technique (r=0.3, p=0.001). On the other hand, there were correlations between the number of errors and degree of bronchial obstruction, asthma control, severity of dyspnea by mMRC score, exacerbation rate.

Conclusion. Patients with bronchoobstructive diseases perform many inhaler errors, that substantially influences the severity and course of asthma and chronic obstructive pulmonary disease.

About the authors

Natalia V. Trushenko

Sechenov First Moscow State Medical University (Sechenov University); Federal Pulmonology Research Institute

Author for correspondence.
Email: trushenko.natalia@yandex.ru
ORCID iD: 0000-0002-0685-4133

канд. мед. наук, ассистент, науч. сотр. клин. лаб.

Russian Federation, Moscow; Moscow

Anna A. Stoliarevich

Botkin City Clinical Hospital

Email: stoliarevich@yandex.ru

клин. ординатор

Russian Federation, Moscow

Boris G. Andriukov

Central State Medical Academy Presidential Administration

Email: aborigen8698@yandex.ru

клин. ординатор, каф. терапии, кардиологии и функциональной диагностики с курсом нефрологии ФГБУ ДПО ЦГМА

Russian Federation, Moscow

Galiya S. Nuralieva

Sechenov First Moscow State Medical University (Sechenov University);
Federal Pulmonology Research Institute

Email: trushenko.natalia@yandex.ru
ORCID iD: 0000-0002-4726-4906

канд. мед. наук, доц. каф. пульмонологии; науч. сотр. лаб. интенсивной терапии и дыхательной недостаточности

Russian Federation, Moscow; Moscow

Natalya A. Tsareva

Sechenov First Moscow State Medical University (Sechenov University); Federal Pulmonology Research Institute

Email: trushenko.natalia@yandex.ru

канд. мед. наук, доц. каф. пульмонологии, науч. сотр. лаб. интенсивной терапии и дыхательной недостаточности

Russian Federation, Moscow; Moscow

Baina B. Lavginova

Sechenov First Moscow State Medical University (Sechenov University)

Email: trushenko.natalia@yandex.ru

студентка 6-го курса

Russian Federation, Moscow

Sergey N. Avdeev

Sechenov First Moscow State Medical University (Sechenov University); Federal Pulmonology Research Institute

Email: serg_avdeev@list.ru
ORCID iD: 0000-0002-5999-2150

акад. РАН, д-р мед. наук, проф., зав. каф. пульмонологии, рук. клин. отд. 

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. Frequency of errors in inhalation technique for different devices.

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3. Fig. 2. The relationship between intensity of dyspnea (mMRC) and inhalation technique.

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4. Fig. 3. Relationship between results of functional tests and errors in inhalation technique.

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