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
Observational Study
. 2016;53(3):321-9.
doi: 10.3109/02770903.2015.1099160. Epub 2016 Jan 26.

Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting

Janine A M Westerik  1 , Victoria Carter  2 , Henry Chrystyn  1   3 , Anne Burden  1 , Samantha L Thompson  1 , Dermot Ryan  4 , Kevin Gruffydd-Jones  5 , John Haughney  6 , Nicolas Roche  7 , Federico Lavorini  8 , Alberto Papi  9 , Antonio Infantino  10 , Miguel Roman-Rodriguez  11 , Sinthia Bosnic-Anticevich  12 , Karin Lisspers  13 , Björn Ställberg  13 , Svein Høegh Henrichsen  14 , Thys van der Molen  15 , Catherine Hutton  1 , David B Price  1   6
Affiliations
Observational Study

Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting

Janine A M Westerik et al. J Asthma. 2016.

Abstract

Objective: Correct inhaler technique is central to effective delivery of asthma therapy. The study aim was to identify factors associated with serious inhaler technique errors and their prevalence among primary care patients with asthma using the Diskus dry powder inhaler (DPI).

Methods: This was a historical, multinational, cross-sectional study (2011-2013) using the iHARP database, an international initiative that includes patient- and healthcare provider-reported questionnaires from eight countries. Patients with asthma were observed for serious inhaler errors by trained healthcare providers as predefined by the iHARP steering committee. Multivariable logistic regression, stepwise reduced, was used to identify clinical characteristics and asthma-related outcomes associated with ≥1 serious errors.

Results: Of 3681 patients with asthma, 623 (17%) were using a Diskus (mean [SD] age, 51 [14]; 61% women). A total of 341 (55%) patients made ≥1 serious errors. The most common errors were the failure to exhale before inhalation, insufficient breath-hold at the end of inhalation, and inhalation that was not forceful from the start. Factors significantly associated with ≥1 serious errors included asthma-related hospitalization the previous year (odds ratio [OR] 2.07; 95% confidence interval [CI], 1.26-3.40); obesity (OR 1.75; 1.17-2.63); poor asthma control the previous 4 weeks (OR 1.57; 1.04-2.36); female sex (OR 1.51; 1.08-2.10); and no inhaler technique review during the previous year (OR 1.45; 1.04-2.02).

Conclusions: Patients with evidence of poor asthma control should be targeted for a review of their inhaler technique even when using a device thought to have a low error rate.

Keywords: Asthma therapy; Diskus inhaler; cross-sectional; inhalation devices; multinational.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Percentage of patients making each type of serious inhaler error with the Diskus.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB, Weiss ST. Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol. 2004;114:40–47. - PubMed
    1. Demoly P, Gueron B, Annunziata K, Adamek L, Walters RD. Update on asthma control in five European countries: results of a 2008 survey. Eur Respir Rev. 2010;19:150–157. - PMC - PubMed
    1. Price D, Fletcher M, van der Molen T. Asthma control and management in 8 000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med. 2014;24:14009. - PMC - PubMed
    1. Price D, Bosnic-Anticevich S, Briggs A, Chrystyn H, Rand C, Scheuch G, Bousquet J. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respir Med. 2013;107:37–46. - PubMed
    1. Laube BL, Janssens HM, de Jongh FH, Devadason SG, Dhand R, Diot P, Everard ML, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308–1331. - PubMed

Publication types