The Assessment of Correct Usage of Inhalers by Elderly Patients with COPD and Asthma

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation. Inhaled metered dose inhalers (MDI) is commonly prescribed for the treatment of asthma and chronic obstructive pulmonary disease (COPD), but it often not properly used by elderly patients. Older people commonly have poor inhaler technique. If these medications are not used properly, they will not be effective. The purpose of this study was to assess the correct usage of inhalers by elder patients. In this cross-sectional study, 150 elderly patients with asthma and chronic obstructive pulmonary disease were selected by convenience sampling method in Boo-Ali and Velayat Hospital of Qazvin. Data collection was done by use of demographic and clinical questionnaires. Using a standardized inhaler-specific checklist, the inhalation technique was assessed, too. Following observation of the inhalation technique, the check list was scored from 0 to 16. All of the 150 elderly participants (mean age: 73.44±7.23 years, 64.1% male, 79.3% with primary school education) failed to use their inhalers correctly and performed at least one mistake in the inhalation technique. The mean±SD score of the correct usage of inhalers was 9.42±2.67. The least skills was related to rinse mouth with water, following inhaler usage (1.3%). The proper performed skills were exhaling prior to inhalation (18.7%), waiting 1 minute before a needed extra dose (28.7), breath-hold for about 5-10 seconds (34%), breathe out slowly away from mouthpiece (34%), holding breath while remove inhaler from mouth (47.3%) and breathe in slowly through mouth for about 3-5 seconds at start of inspiration (51.3%). Receiving previous training was the most important factor related to inhalation technique (P=0.001). No associations were found between inhalation technique and another demographic and clinical variable. Training elderly patients with COPD and asthma to use MDIs properly is the essential component for their prescription and special attention should be given to education regarding inhaler techniques, in order to increase the effectiveness of medications.