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Age and Ageing, Vol 28, 481-484, Copyright © 1999 by British Geriatrics Society

ARTICLES

A comparison of large volume spacer, breath-activated and dry powder inhalers in older people

V Jones, C Fernandez and P Diggory
Department of Elderly Care Medicine, Mayday Hospital, Croydon, UK.

AIMS: To see if elderly people can use the breath-activated (Easi- breathe) and dry powder (Turbohaler) inhalers as effectively as the metered-dose inhaler and Volumatic system. METHODS: 102 inhaler-naive patients (aged 75-101, mean 84 years), without cognitive impairment, were randomly allocated one of Easi-breathe, Turbohaler or metered-dose inhaler and Volumatic placebo inhalers. Standardized tuition was done on enrolment and at 6 h review. Inhaler technique was assessed immediately after enrolment tuition and at 6 and 24 h. Assessment was by scoring (0 = poor, 1 = moderate, 2 = perfect) five aspects of technique. RESULTS: Mean total scores were significantly (P < 0.005) higher for Turbohaler and Easi-breathe than metered-dose inhaler and Volumatic on enrolment and 6 h and at 24 h (P < 0.045). Fewer patients achieved excellent scores of 9 or 10 when using metered-dose inhaler and Volumatic. The main difficulties were in assembling the metered- dose inhaler and Volumatic and detecting when the metered-dose inhaler and Volumatic or Easi-breathe was empty. CONCLUSIONS: Breath-activated and dry powder inhalers were more likely to be used correctly than metered-dose inhalers with large volume spacers.
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