Age and Ageing 2004; 33: 185-188
© 2004, British Geriatrics Society
Research Paper |
Inhaler technique in older people in the community
1 Royal Shrewsbury Hospital, Shrewsbury, Shropshire SY3 8XQ, UK
2 University Department of Geriatric Medicine, Llandough Hospital, Cardiff CF64 2XX, UK
3 Welsh Cancer Intelligence and Surveillance Unit, Cardiff CF1 9LJ, UK
4 Department of Epidemiology, Statistics and Public Health Medicine, University of Wales College of Medicine, Cardiff CF14 4XN, UK
Address correspondence to: M. S. O’Mahony, University Department of Geriatric Medicine, 3rd Floor, Academic Centre, Llandough Hospital, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, UK. Fax: (+44) 29 20 711267. Email: omahonyms{at}cf.ac.uk
Abstract
Background: good inhaler technique and medication concordance is important for symptom and disease control in chronic airways disease.
Objectives: establish the prevalence of inhaler use; the main inhaler devices used by older people at home; their ability to use the inhalers they have been prescribed; and the relationship between perceived ease of use and actual performance.
Design: cross-sectional population based study.
Subjects: subjects aged 70 years and over living at home.
Methods: 500 subjects were randomly selected from 5,002 subjects aged 70 years and over living at home. Inhalers used over the previous 24 hours were identified by a nurse on home visit. Those with cognitive impairment were excluded. Inhaler system was assessed and graded by a doctor as acceptable (perfect or minor errors) or unacceptable (major errors), using previously published criteria. Perceived ease of use of the device was rated as easy, moderate or difficult.
Results: 423 subjects participated in the study. The population prevalence of inhaler use was 15.8% (12.0, 19.7). Of the 91 inhaler devices used, 39 (42.8%) were metered dose inhalers, 34 (37.4%) were metered dose inhalers with large volume spacers, and 18 (19.8%) were breath-actuated devices. Thirty-two subjects (82.1%) using metered dose inhalers had an acceptable technique compared with 33 (97.1%) of those using metered dose inhalers with large volume spacers and 13 (72.2%) of those using breath-actuated devices (P < 0.05). Up to three quarters of inhalers were considered easy to use but 12% of subjects who rated their inhaler device as being easy to use made major errors.
Conclusion: metered dose inhaler was the most frequently prescribed inhaler and was used correctly by most subjects especially in combination with large volume spacers. Major errors were more common with breath-actuated devices. Inhaler technique should be checked as patients’ perception of their inhaler skills correlates poorly with actual performance.
Keywords: older people, population study, inhaler use and technique
Received March 24, 2003; accepted in revised form October 15, 2003.
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