title: Effect of training by a physician on dynamics of the use of inhaler devices to improve technique in patients with obstructive lung diseases.
abstract: BACKGROUND
  Pharmacotherapies for obstructive lung diseases are dependent on agents delivered via inhaler devices, and the correct technique is essential for efficiency of these drugs.
  
  
  OBJECTIVE
  To determine the rate of incorrect inhaler techniques among patients with pulmonary diseases and the efficacy of delivering physician-provided training to patients by letting them practice with their inhaler devices.
  
  
  METHODS
  Patients ages ≥18 years with asthma, chronic obstructive pulmonary disease, or asthma chronic obstructive pulmonary disease overlap syndrome were enrolled. At the first visit, the patients were requested to use their own inhalers that they were currently on for initial evaluation of their inhalation technique. Correct and incorrect techniques were determined according to steps previously described in the literature. At the same visit, the physician provided practical training on faulty techniques detected, and a control visit was scheduled.
  
  
  RESULTS
  The study involved 108 patients, and 158 different inhalation techniques were assessed. Types of inhaler devices included in the study were metered-dose inhaler and five types of dry-powder inhalers. Fifty-six incorrect practices (35.4%) were noted. Although 64 patients (59.3%) used all of their inhaler devices with the correct technique, 44 (40.7%) used one or more inhalers inappropriately. At the control visit, the patients who misused their inhalers decreased significantly, to 8.3% (p < 0.001). The faulty technique ratio was decreased to 7.0%, which yielded the success of practical training as 80.4%.
  
  
  CONCLUSIONS
  Incorrect inhaler technique is still a problem for patients with obstructive lung diseases even in urbanized areas. Physician-provided practical training on the use of inhaler devices was an effective tool in the correction of inhaler techniques.
authors.affiliation: Chest Diseases Department, Ankara, Hacettepe University Faculty of Medicine, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Aksu
authors.forename: Ayşe Demirci
authors.initials: AD
authors.lastname: Şahin
authors.forename: Tijen
authors.initials: T
authors.lastname: Şengezer
authors.forename: Kurtuluş
authors.initials: K
authors.lastname: Aksu
mesh_terms: D000328:Adult; D001249:Asthma / Q000188:drug therapy; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D010819:Physician's Role; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D012307:Risk Factors