Respiratory Compromise

Proper Inhaler Use Can Prevent Many Instances of Respiratory Compromise Doctors Should Ensure that Patients are Using Their COPD Inhalers Properly

Proper inhaler use can prevent many instances of respiratory compromise.  In a recent survey, “The Role of Inhalation Delivery Devices in COPD: Perspectives of Patients and Health Care Providers,” researchers from the American College of Chest Physicians surveyed 513 healthcare providers managing COPD and 499 patients with COPD across the United States and found that both patients and healthcare providers place less importance on inhaler devices than medication in the treatment of chronic obstructive pulmonary disease (COPD) and concluded:

“our findings unveil important HCP and patient perspectives about the role of inhalation devices in COPD treatment. Of note, both groups place more importance on the actual medication than its delivery device.”

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In a recent clinical education podcast featuring the Society of Hospital Medicine’s COPD team, Dr. Valerie Press, who is Assistant Professor of Internal Medicine and Pediatrics at the University of Chicago, said that if she could provide one recommendation to patients and clinicians, it would be to ensure that inhalers are being used properly:

“I think that if I had one shot at patients and providers, I would say at least know that inhaler technique is a problem. I’ve studied this and I know that patients aren’t always aware that they’re not using their inhalers correctly and providers across the board often don’t realize this, as well. We often, as physicians or nurse practitioners, write prescriptions and don’t realize that patients aren’t using their inhalers correctly and how tricky it can be to really get the medicine from the inhaler device into the lungs. 

 There are lots of different inhaler devices out there. They each have their own unique sets of steps and tricks to use them correctly.”

She then discussed some examples:

“A great example of that is with a metered dose inhaler. I is pressurized, so when you press the inhaler device, the medicine is released very, very quickly and patients really need a device that we often refer to as a spacer device to allow timing to get into the lungs. Patients often don’t have that spacer device and their natural instinct is to breath in too quickly and they really need to breathe in slowly to get that medicine into their lungs. 



“There are other inhalers and they have dry powder in them. These in contrast actually require patients to take really brisk, strong breaths in to get that medicine into their lungs. And, so you can see how different techniques need to be applied differently for that the type of inhalers.”

Source: https://journal.copdfoundation.org/jcopdf/id/1184/The-Role-of-Inhalation-Delivery-Devices-in-COPD-Perspectives-of-Patients-and-Health-Care-Providers

Source: https://journal.copdfoundation.org/jcopdf/id/1184/The-Role-of-Inhalation-Delivery-Devices-in-COPD-Perspectives-of-Patients-and-Health-Care-Providers

In the 2017 recommendations from the Global Initiative for Chronic Obstructive Lung Disease (otherwise known as GOLD) regular assessment of inhaler technique is recommended.

 

To listen to the clinical education podcast with Dr. Press and the rest of SHM’s COPD team, please click here.

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