Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar 6;9(1):8.
doi: 10.1186/1710-1492-9-8.

Improper inhaler technique is associated with poor asthma control and frequent emergency department visits

Hamdan Al-Jahdali  1 , Anwar Ahmed, Abdullah Al-Harbi, Mohd Khan, Salim Baharoon, Salih Bin Salih, Rabih Halwani, Saleh Al-Muhsen
Affiliations

Improper inhaler technique is associated with poor asthma control and frequent emergency department visits

Hamdan Al-Jahdali et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Uncontrolled asthma remains a frequent cause of emergency department (ED) visits and hospital admissions. Improper asthma inhaler device use is most likely one of the major causes associated with uncontrolled asthma and frequent ED visits.

Objectives: To evaluate the inhaler technique among asthmatic patients seen in ED, and to investigate the characteristics of these patients and factors associated with improper use of inhaler devices and its relationship with asthma control and ED visits.

Methods: A cross-sectional study of all the patients who visited the ED with bronchial asthma attacks over a 9-month period was undertaken at two major academic hospitals in Saudi Arabia. Information was collected about demographic data and asthma management and we assessed the inhaler techniques for each patient using an inhaler technique checklist.

Results: A total of 450 asthma patients were included in the study. Of these, 176(39.1%) were males with a mean age of 42.3 ±16.7 years and the mean duration of asthma was 155.9 ± 127.1 weeks. The improper use of asthma inhaler devices was observed in 203(45%) of the patients and was associated with irregular clinic follow-ups (p = 0.0001), lack of asthma education (p = 0.0009), uncontrolled asthma ACT (score ≤ 15) (p = 0.001), three or more ED visits (p = 0.0497), and duration of asthma of less than 52 weeks (p = 0.005). Multiple logistic regression analysis revealed that a lack of education about asthma disease (OR =1.65; 95% CI: 1.07, 2.54) or a lack of regular follow-up (OR =1.73; 95% CI: 1.08, 2.76) was more likely to lead to the improper use of an asthma inhaler device.

Conclusion: Improper asthma inhaler device use is associated with poor asthma control and more frequent ED visits. We also identified many avoidable risk factors leading to the improper use of inhaler devices among asthma patients visiting the ED.

PubMed Disclaimer

References

    1. NIH. National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma. Bethesda (MD): National Heart, Lung, and Blood Institute. NIH Publication No. 07-4051. NIH Publication No 07-4051; 2007.
    1. Turner S, Paton J, Higgins B, Douglas G. British guidelines on the management of asthma: what's new for 2011? Thorax. 2011;66(12):1104–5. doi: 10.1136/thoraxjnl-2011-200213. - DOI - PubMed
    1. Gupta RS, Weiss KB. The 2007 national asthma education and prevention program asthma guidelines: accelerating their implementation and facilitating their impact on children with asthma. Pediatrics. 2009;123(Suppl 3):S193–8. - PubMed
    1. Al Frayh AR, Shakoor Z, Gad El Rab MO, Hasnain SM. Increased prevalence of asthma in Saudi Arabia. Ann Allergy Asthma Immunol. 2001;86(3):292–6. doi: 10.1016/S1081-1206(10)63301-7. - DOI - PubMed
    1. al Frayh AR, Al Nahdi M, Bener AR, Jawadi TQ. Epidemiology of asthma and allergic rhinitis in two coastal regions of Saudi Arabia. Allerg Immunol (Paris) 1989;21(10):389–93. - PubMed