title: Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique.
abstract: BACKGROUND
  Patient compliance, inhalation devices, and inhalation techniques influence the effectiveness of inhaled medications.
  
  
  METHODS
  This article presents the results of a systematic literature review of studies measuring compliance with inhaled corticosteroids, measuring inhalation technique with different inhalation devices, and estimating the proportion of inhaled drug that is deposited in the lung.
  
  
  RESULTS
  Overall, patients took the recommended doses of inhaled medication on 20 to 73% of days. Frequency of efficient inhalation technique ranged from 46 to 59% of patients. Education programs have been shown to improve compliance and inhalation techniques. The lung deposition achieved with different inhalers depends on particle size as well as inhaler technique.
  
  
  CONCLUSIONS
  This review demonstrates that multiple factors may come between a prescription of an inhaled corticosteroid and the arrival of that medicine at its target organ, the lung.
authors.affiliation: Guy's Hospital, London, UK.
authors.forename: M G
authors.initials: MG
authors.lastname: Cochrane
authors.forename: M V
authors.initials: MV
authors.lastname: Bala
authors.forename: K E
authors.initials: KE
authors.lastname: Downs
authors.forename: J
authors.initials: J
authors.lastname: Mauskopf
authors.forename: R H
authors.initials: RH
authors.lastname: Ben-Joseph
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000328:Adult; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D004867:Equipment Design; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000378:metabolism; D009330:Nebulizers and Vaporizers; D010349:Patient Compliance; D010353:Patient Education as Topic; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones