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
Review
. 2019 Mar 14:15:461-472.
doi: 10.2147/TCRM.S160365. eCollection 2019.

Choosing the right inhaler for your asthma or COPD patient

Omar S Usmani  1
Affiliations
Review

Choosing the right inhaler for your asthma or COPD patient

Omar S Usmani. Ther Clin Risk Manag. .

Abstract

Appropriate selection and correct use of inhalation devices is an integral component in the management of asthma and chronic obstructive pulmonary disease (COPD). It is well known that there are many challenges with the use of inhalers, and no one device suits all patients. Challenges can range from difficulties related to lung disease severity and pulmonary function to physical considerations, including manual dexterity and comorbidities such as arthritis. In terms of device selection and adherence, patient engagement and satisfaction are also important factors to consider. Furthermore, problems with inhaler use can be most evident in children and older patients. Here, we discuss aspects for consideration with commonly used devices, including nebulizers, pressurized metered-dose inhalers, dry powder inhalers, and the soft mist inhaler. As each inhaler offers varying technical properties, a tailored and personalized approach to the selection of the most appropriate device for the patient is highly recommended in order to increase the likelihood of achieving improved disease outcomes and enhance persistence with device adherence. Importantly, education and support is crucial, not only to enable patients to recognize the need for optimal disease management, but also to help them develop good inhaler technique. In addition, health care professionals should also aim to increase their knowledge of the devices they prescribe, and develop systems to ensure that they offer comprehensive support to patients in clinical practice. Considering these aspects, this review discusses potential strategies to help address the challenges of inhaler use in asthma and COPD.

Keywords: COPD; adherence; asthma; inhaler.

PubMed Disclaimer

Conflict of interest statement

Disclosure OSU has received industry–academic funding from Boehringer Ingelheim, Chiesi, Edmond Pharma, GlaxoSmithKline, and Mundipharma International, and has received consultancy or speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Edmond Pharma, GlaxoSmithKline, Mundipharma International, Napp, Novartis, Pearl Therapeutics, Roche, Sandoz, Takeda, UCB, Vectura, and Zentiva. The author reports no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Challenges of inhalation therapy in pediatric patients, and age-appropriate inhaler devices and interfaces. Note: Data from these studies.,,, Abbreviations: DPI, dry powder inhaler; pMDI, pressurized metered-dose inhaler; SMI, soft mist inhaler; VHC, valved holding chamber.
Figure 2
Figure 2
Challenges with the use of inhalation therapy in elderly patients, and an algorithm for appropriate inhaler device selection.,, Abbreviations: COPD, chronic obstructive pulmonary disease; HCP, health care professional.
See this image and copyright information in PMC

References

    1. Lewis A, Torvinen S, Dekhuijzen PN, et al. The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries. BMC Health Serv Res. 2016;16:251. - PMC - PubMed
    1. Asthma UK Asthma facts and statistics. [Accessed February 12, 2018]. Available from: https://www.asthma.org.uk/about/media/facts-and-statistics/
    1. World Health Organization Chronic respiratory diseases. [Accessed October 26, 2017]. Available from: http://www.who.int/respiratory/en/
    1. Stein SW, Thiel CG. The history of therapeutic aerosols: a chronological review. J Aerosol Med Pulm Drug Deliv. 2017;30(1):20–41. - PMC - PubMed
    1. Lavorini F, Corrigan CJ, Barnes PJ, et al. Aerosol Drug Management Improvement Team Retail sales of inhalation devices in European countries: so much for a global policy. Respir Med. 2011;105(7):1099–1103. - PubMed