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Thursday, July 23, 2015

Patients must learn proper inhaler technique

It is important that healthcare providers -- particularly respiratory therapists, nurses, and physicians -- adequately teach respiratory patients the proper technique for using inhalers.  This is especially important now that there are so many different types of inhalers on the market.

One recent issue that came up were reports to the American Association of Poison Control Center's National Poison Data System and the FDA about patients ingesting the capsules rather than inhaling them. Poison control probably had to educate people that swallowing the capsules would not poison them, as acids in the stomach would break down the medicine before it gets to the system.  

So the safety issue here was not so much poison, as it was that these patients were not getting the benefits of the medicine.  The bottom line is that ingesting the capsules rendered them useless.

This is a quintessential example of poor inhaler training.  It's also a perfect example that shows that it should not be assumed that patients can figure out how to use inhalers on their own.

The fact of the matter is, not even the most well educated and seasoned asthmatics use their inhalers correctly.  Therefore, it should never be assumed a patient will figure it out on their own, or that even the most seasoned asthmatics are using their inhalers properly.

Most experts now recommend that all patients be educated on trained on proper inhaler use when they are given new inhalers, and then the patient should be asked to demonstrate proper use with each subsequent visit.

In February, 2008, The FDA issued a public health advisory highlighting the correct way to use Foradil. The purpose was to assure healthcare providers were aware patients were using them wrong, in order so they could make sure their patients are using them correctly.

The FDA has also been made aware that similar occurrences were reported regarding the Spiriva HandiHalter (tiotropium). That issue was also addressed.

In the past ten years there have been a ton of new inhalers enter the market.  Many times I have had to Google how to use an inhaler before teaching it to a patient.  While using most of these inhalers is generally easy, they can also be confusing and even frustrating to patients.

Bottom line: every time we as healthcare providers  -- and this included respiratory therapists, nurses, and physicians --see chronic lungers we ought to be asking them if they have inhalers, and we should be making sure they are using them correctly.

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