What factors influence proper inhaler technique among persons with COPD? A recent study found out--and this quick quiz tests your assumptions.
Inhaled medication is the foundation of chronic obstructive pulmonary disease (COPD) treatment and therapeutic success depends on proper inhalation technique. Clinical studies have found, however, that approximately 94% of patients mishandle their inhalation devices (IDs), placing them at increased risk for COPD exacerbations. What factors impact a patient’s ability to correctly use an ID?
Authors of a recent study examined the inhalation technique of 300 stable COPD patients aged >40 years who performed 521 inhalation maneuvers with 10 different IDs. They assessed whether accurate inhalation technique is associated with a variety of factors, including the number of IDs used, patient demographics and clinical and functional characteristics, and patient beliefs about IDs. What did the study find?
Click through the 8 questions below to find out.
Question 1. Among the 521 inhalation maneuvers demonstrated, at least 1 incorrect step was found in approximately what percentage of demonstrations?
Answer: D. 48%. At least 1 incorrect step was found in 48.2% of inhalation demonstrations; critical errors (incorrect priming or loading; incorrect inhalation) were observed in 29.9%.
Question 2. Among the 156 (29.9%) demonstrations with critical errors, which of the above ID types had the highest percentage of observed critical errors?
Answer: A. pMDI. Among the 156 inhalation demonstrations with critical errors, 53.6% were observed with pMDIs, followed by 28.4% with a soft-mist inhaler, 26.8% with mDPIs, and 24.2% with sDPIs. Also, pMDIs had a significantly higher percentage of critical errors related to inhalation maneuvers (30.6%) vs priming/loading (5.8%).
Question 3. Among the 300 patients examined, approximately what percentage demonstrated misuse due to critical errors?
Answer: D. 39%. A total of 39.3% demonstrated misuse due to critical errors with a higher percentage of women (52.1%) demonstrating critical errors vs men (35.4%).
Question 4. True or false? There was a higher percentage of misuse related to priming or loading IDs vs inhalation maneuver.
Answer: B. False. Misuse was related to priming/loading IDs in 6.9% of demonstrations vs 13.1% related to inhalation maneuver. Misuse was related to both in 10% of demonstrations. More difficulty with inhalation maneuver was seen with pMDI, in priming with a Turbuhaler® (mDPI), and in both maneuvers with a Handihaler® (sDPI).
Question 5. Among the 10 ID types used in the study, which one of the above was NOT incorrectly used?
Answer: C. Aeroliser.® Aeroliser,® a sDPI, was the only brand that was not incorrectly used by participants and showed no critical errors related to priming/loading or inhalation maneuver.
Question 6. True or false? Patients incorrectly performed more inhalation maneuvers when they used 1 inhaler vs 4 inhalers.
Answer: B. False. Incorrect use was performed in 31.6% of demonstrations with 1 inhaler, 24.8% with 2 inhalers, 33.4% with 3 inhalers, and 66.7% with 4 inhalers.
Question 7. Among the 239 demonstrations using a mDPI, approximately what percentage of critical errors seen were related to inhalation maneuvers?
Answer: D. 11%. Demonstrations using a mDPI showed more critical errors related to inhalation maneuvers (11.8%) vs priming/loading (8.4%).