title: Physicians' knowledge of inhaler devices and inhalation techniques remains poor in Spain.
abstract: BACKGROUND
  Studies in many countries in the 1990s revealed deficiencies in physicians' knowledge about inhalation therapy. In an attempt to remedy this situation, Spanish scientific societies implemented a variety of educational strategies. The objective of the present study was to assess changes in attitudes and knowledge about inhalers and inhalation techniques in a sizable sample of physicians.
  
  
  METHODS
  An 11-question multiple choice test was developed and administered throughout Spain to practicing physicians from specialties that frequently prescribe inhaler devices. The survey collected demographic characteristics (four items), preferences (two items), and issues related to knowledge (three items) and education (two items) about devices and inhalation techniques. Completion of the questionnaire was voluntary, individual, and anonymous.
  
  
  RESULTS
  A total of 1514 respondents completed the questionnaire. Dry powder inhalers (DPI) were preferred by 61.2% physicians, but only 46.1% identified "inhale deeply and forcefully" as the most significant step in the inhalation maneuver using these devices. Only 27.7% stated that they always checked the patient's inhalation technique when prescribing a new inhaler. A composite variable, general inhaled therapy knowledge, which pooled the correct answers related to knowledge, revealed that only 14.2% physicians had an adequate knowledge of inhaled therapy. Multivariate analysis showed that this knowledge was lowest among internal medicine and primary care physicians.
  
  
  CONCLUSIONS
  Prescribers' knowledge of inhalers and inhalation techniques remains poor in Spain. The causes should be identified in further research to allow effective educational strategies to be developed. Specific educational policies should be addressed to general practitioners.
authors: Service of Pneumology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain. vplaza@santpau.cat
authors: Vicente
authors: V
authors: Plaza
authors: Joaquín
authors: J
authors: Sanchis
authors: Pere
authors: P
authors: Roura
authors: Jesús
authors: J
authors: Molina
authors: Myriam
authors: M
authors: Calle
authors: Santiago
authors: S
authors: Quirce
authors: José Luís
authors: JL
authors: Viejo
authors: Fernando
authors: F
authors: Caballero
authors: Cristina
authors: C
authors: Murio
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009330:Nebulizers and Vaporizers; D010820:Physicians; D013030:Spain