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Two thirds of COPD patients use inhalers incorrectly

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The majority of chronic obstructive pulmonary disease patients are not using their inhalers correctly and are, therefore, not getting sufficient medication to their lungs, warn researchers.

The result, they said, was that COPD patients were experiencing more potentially life-threatening, exacerbations.

“Health professionals really need to use every chance to educate people about inhaler technique”

Breda Cushen

Based on their findings, the researchers from Royal College of Surgeons in Ireland called for health professionals to take every opportunity to check inhaler technique and provide education.

It could have a huge positive impact on patient health and wellbeing, they said in research papers presented at the British Thoracic Society’s winter meeting today.

Over three years, the study reviewed a full month of inhaler use among 244 COPD patients by using an electronic audio recording tool, which was developed by the college and Trinity College Dublin.

The acoustic recorder tracked any problems, such as the patient not generating enough airflow to get the right level of medication into their lungs.

The trial showed that a third of patients thought they were using their inhaler properly, but the tracking device revealed that they were not.

In fact, two thirds were not using their inhaler correctly most of the time and those with poor inhaler use were suffering more flare-ups. Only 6% showed correct inhaler use for 80% or more of the time.

“These recommendations provide an alternative approach to care”

Morag Farquhar

Dr Breda Cushen, research registrar at the college and a member of the British Thoracic Society, said: “We know that with medication in general, and particularly with inhalers, adherence can be very poor.

“This means that people are simply not inhaling the medication they need, and as a direct result, their breathlessness gets worse,” she said.

“Health professionals really need to use every chance – in the community or in hospital – to check, and educate people about, their inhaler technique,” said Dr Cushen.

She added: “It could make a huge difference to people’s lives allowing them to breath easier and reducing the number of flare-ups they experience.”

Another major COPD study, also presented at the conference, outlined the key steps needed to improve care and support for those living with advanced COPD.

The research, funded by Marie Cure and the National Institute of Health Research, questioned 500 patients, carers, and key health professionals, over 18 months. The study authors identified six key recommendations based on their findings.

This included a need to stop focusing on the “challenges and unpredictability” of COPD as barriers to meeting patient needs, and to change targets from reactive reviews of the condition to encouraging proactive person-centred care.

They also recommended a need to identify and respond to patient support needs, identify and support informal carers, respond to psychological distress in patients and carers, and challenge and change societal attitudes associated with COPD and palliative care.

University of East Anglia

Two thirds of COPD patients use inhalers incorrectly

Morag Farquhar

Study author Dr Morag Farquhar, senior lecturer at the University of East Anglia, said: “Care can be very challenging for those living with advanced COPD – and it impacts considerably on their informal carers. Supporting them is a challenge for healthcare professionals.

“There is a knowledge gap in advanced COPD. We currently rely on end of life care frameworks developed for cancer with its much more predictable trajectory,” said Dr Farquhar.

“By gathering evidence from patients, carers, and healthcare professionals as well as consulting stakeholders we have addressed this gap by identifying six key recommendations, and actions to enable them, to improve care and support of those living with advanced COPD,” she said.

She added: “These recommendations provide an alternative approach to care and support for patients with advanced COPD and their families.”

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