title: A study to assess inhaler technique and its potential impact on asthma control in patients attending an asthma clinic.
abstract: OBJECTIVE
  The aim of this study was to evaluate inhaler technique and symptom control in patients with poorly controlled asthma at baseline and at follow-up in a dedicated asthma clinic in a tertiary hospital. We also investigated the impact of asthma on these patients' quality of life.
  
  
  METHODS
  Patients referred to a newly established asthma clinic in Cork University Hospital were prospectively recruited over a 6-month period. Their inhaler technique was assessed by a pulmonary nurse specialist using a validated scoring system. They received instruction on inhaler usage when scores were suboptimal. Patients completed a validated asthma control questionnaire (ACQ) and asthma quality of life questionnaire (AQLQ). At follow-up 3-4 months later, the inhaler technique was reassessed and the ACQ questionnaire repeated.
  
  
  RESULTS
  Forty-six patients were recruited (female = 74%), and 40/46 were followed up. Mean [SD] FEV1 % predicted at baseline = 76.5% [21.5]. About 63% of the patients were classified as incorrectly using their inhaler at their initial assessment. This decreased to 20% at follow-up, indicating an overall significant improvement in inhaler usage post-training (p = 0.003). ACQ scores improved significantly from median [interquartile range] 2.70 [1.66] to 2.00 [1.90] (p = 0.002). Baseline measurement indicated that patients' quality of life was moderately affected by asthma, with a median AQLQ score of 4.75 [1.97].
  
  
  CONCLUSIONS
  This study demonstrates the importance of educating and formally assessing inhaler technique in patients with asthma as a part of their ongoing clinical review.
authors.affiliation: The Department of Respiratory Medicine, Cork University Hospital, University College Cork , Cork , Ireland.
authors.forename: C M
authors.initials: CM
authors.lastname: Harnett
authors.forename: E B
authors.initials: EB
authors.lastname: Hunt
authors.forename: B R
authors.initials: BR
authors.lastname: Bowen
authors.forename: O J
authors.initials: OJ
authors.lastname: O'Connell
authors.forename: D M
authors.initials: DM
authors.lastname: Edgeworth
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: J A
authors.initials: JA
authors.lastname: Eustace
authors.forename: M T
authors.initials: MT
authors.lastname: Henry
authors.forename: M P
authors.initials: MP
authors.lastname: Kennedy
authors.forename: B J
authors.initials: BJ
authors.lastname: Plant
authors.forename: D M
authors.initials: DM
authors.lastname: Murphy
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D000554:Ambulatory Care Facilities; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D011786:Quality Control; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents