title: Improving inhaler technique, adherence to therapy and the precision of dosing: major challenges for pulmonary drug delivery.
abstract: BACKGROUND
  The inhaled route has many advantages, but requires the patient to use, and to master the use of, an inhaler device. Poor inhaler technique and non-adherence to therapy lead to a highly variable lung dose in clinical practice, with subsequent loss of clinical efficacy and wastage of economic resources.
  
  
  METHODS
  This paper discusses problems of poor inhaler technique, non-adherence to inhaler therapy, other issues relating to the precision of dose delivery, the consequences of these problems and how they can be addressed.
  
  
  CONCLUSIONS
  The precision of dosing by the pulmonary route can be improved by appropriate choice of inhaler device and by education. It is vital to educate patients about their disease, about the importance of taking prescribed medications and about correct inhaler use. One-on-one sessions with healthcare professionals probably represent the most effective educational method. For some drugs and patient groups, inhalers containing small microprocessors may also be used to control inhalation technique, and hence, to obtain a more reproducible lung dose. As the range of drugs delivered by inhalation increases, the need for correct inhaler technique, adherence to therapy and precise dosing becomes more and more important.
authors.affiliation: Scientific Consultant , Norfolk , UK +44 1485 533140 ; steve.newman@physics.org.
authors.forename: Stephen
authors.initials: S
authors.lastname: Newman
mesh_terms: D000280:Administration, Inhalation; D016503:Drug Delivery Systems; D006801:Humans; D009330:Nebulizers and Vaporizers; D010349:Patient Compliance; D010353:Patient Education as Topic; D004364:Pharmaceutical Preparations / Q000008:administration & dosage
chemical_list: D004364:Pharmaceutical Preparations