Inhaler technique of outpatients in the home.
OBJECTIVE
Assess the role of evaluation, instruction, and use of spacers by patients using metered dose inhalers (MDIs) in the home.


METHODS
Patients (age 64 +/- 15 y [mean +/- standard deviation]) receiving home visits by respiratory care practitioners for oxygen therapy had their inhaler technique checked.


METHODS
A detailed acceptable/unacceptable check-off list was used with 172 patients to evaluate inhaler technique. Patients with poor technique were given instruction and their technique was reassessed. A subgroup of 43 patients was reevaluated on up to 3 visits.


RESULTS
Only 18% of patients using MDIs without spacers were rated acceptable with the detailed check list. Instruction improved inhaler technique, but few patients with initially poor technique without spacers developed fully acceptable technique. Improvements made immediately following instruction were lost when patients were reevaluated months later. Few patients received spacers after they were recommended. Technique was markedly better with spacers. Most patients (76%) had initially proper technique with spacers, and most who had poor technique could learn and retain proper technique.


CONCLUSIONS
Improper inhaler technique without spacers is very common among patients evaluated at home, and the majority of patients were unable to learn and retain proper technique. Most patients would benefit from using spacers with their inhalers. = 33 for first and second. = 26 for third. FRC = functional residual capacity. RV = residual volume. TLC = total lung capacity.¿., Fig. 3¿/PICK;0404f3;;;page;;;;yes;1¿ ¿/GRAPH;rk1000404003;comptd;;center;stack¿ ¿/CAPT;;;center;stack;2112n¿
Johnson
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DH
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA 02114, USA. djohnson@helix.mgh.harvard.edu
Robart
P
P
D000328:Adult; D000368:Aged; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006701:Home Nursing; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010045:Outpatients; D010100:Oxygen / Q000008:administration & dosage*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*
D010100:Oxygen