Effectiveness of Inhaler Devices in Adult Asthma and COPD

Nicolas Roche,1 Henry Chrystyn,2 Federico Lavorini,3 Alvar Agusti,4 J. Christian Virchow,5 Richard Dekhuijzen,6 David Price7

1. Respiratory and Intensive Care Medicine, Cochin Hospital Group, AP-HP, University Paris Descartes, Paris, France
2. Division of Pharmacy and Pharmaceutical Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
3. Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
4. Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Spain; and FISIB, CIBER Enfermedades Respiratorias (CIBERES), Mallorca, Spain
5. Department of Pneumology/Intensive Care Medicine, University of Rostock, Rostock, Germany
6. Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
7. UK Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK

Disclosure: Please refer to page 71.
Received: 27.08.2013 Accepted: 26.09.2013
Citation: EMJ Respir. 2013;1:64-71.


Inhalation therapy remains the cornerstone of treatment for bronchial diseases. Despite being pharmacologically efficacious, currently available inhaled drugs can have decreased real-life effectiveness due to a variety of factors, including poor inhalation technique. Each device type has its own specifications regarding the optimal way to use it, in terms of device handling and characteristics of the inhalation manoeuvre. Poor inhalation technique is associated with decreased treatment effectiveness. Choosing the optimal device, together with proper education, improves inhalation technique, adherence and outcomes or effectiveness, but has to be performed regularly and rigorously, including visual checking of the patient’s ability to use the inhaler. Some testing devices are also available, as well as various training materials. All healthcare professionals caring for the patient can be involved provided that they have also been properly trained. To optimise treatment effectiveness, healthcare providers should prescribe inhalation device(s) optimised to the patient, accounting for the specific characteristics of each individual, his/her disease, and involved healthcare professionals.

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