title: Skills in handling turbuhaler, diskus, and pressurized metered-dose inhaler in korean asthmatic patients.
abstract: OBJECTIVE
  The objective of this study was to evaluate skills in handling inhalers and factors associated with these skills among patients with asthma who had undergone treatment at special asthma and allergy clinics in Korea.
  
  
  METHODS
  We enrolled 78 subjects who used Turbuhaler and 145 who used Diskus for asthma control at special clinics in 10 university hospitals and visually assessed their skills in handling these inhalers. We also evaluated skills in 137 subjects who had used pressurized metered-dose inhalers (pMDIs) for symptom relief. Age, sex, duration of asthma and inhaler use, smoking status, monthly income, highest grade completed in school and previous instruction for handling inhalers were also measured to evaluate their association with overall inhaler skills.
  
  
  RESULTS
  Performance grade was inadequate for 12.8% of participants using Turbuhaler, 6.2% for Diskus, and 23.4% for pMDIs. The success rates for each step in handling the inhalers were relatively high except for the "exhale slowly to residual volume" step, in which success rates ranged from 24.2% to 28.5%. Older age, male sex, lower educational grade, and absence of previous instruction for handling inhalers were associated with inadequate inhaler technique in univariate analysis; however, only older age and absence of previous instruction remained significant independent risk factors in multivariate analysis.
  
  
  CONCLUSIONS
  Among Korean asthmatic patients in special asthma and allergy clinics, skills in handling their inhalers were mostly excellent; meanwhile, older age and absence of previous instruction for handling inhalers were associated with inadequate techniques.
authors.affiliation: Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Chang
authors.forename: Cheol-Woo
authors.initials: CW
authors.lastname: Kim
authors.forename: Tae-Bum
authors.initials: TB
authors.lastname: Kim
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Kim
authors.forename: Yong-Eun
authors.initials: YE
authors.lastname: Kwon
authors.forename: Jong-Myung
authors.initials: JM
authors.lastname: Lee
authors.forename: Soo-Keol
authors.initials: SK
authors.lastname: Lee
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Jeong
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Park
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: Hee-Bom
authors.initials: HB
authors.lastname: Moon
authors.forename: Young-Koo
authors.initials: YK
authors.lastname: Jee