ATS 2018 Perspectives - Episode 7

The Importance of Proper Inhaler Use

The amount of patients with asthma or chronic obstructive pulmonary disease (COPD) who can properly use their inhaler is a debated number. But regardless of its true rate, the number is too low.

One presentation at the 2017 Annual CHEST Meeting last year provided metrics from a recent European study which suggested less than 40% of observed patients were unable to perform a perfect inhalation, regardless of the provided device.

At the 2018 American Thoracic Society (ATS) International Conference in San Diego, CA this year, GlaxoSmithKline reported data which showed patients significantly struggled to manage proper inhaler use when using multiple devices versus a lone device — the triple-therapy Trelegy Ellipta, which is only inhaler therapy of its kind in the US.

In all the current asthma-related issues driven by pediatric obesity, pollution rates, and limited convenient therapy options, that patients being able to adhere to and properly take inhaler therapy is among the issues is almost shocking. But it’s a common conversation in the doctor’s office, Sonali Bose, MD, said.

The assistant professor at the Icahn School of Medicine, Mount Sinai, told MD Magazine that inhaler adherence and proper use is certainly a significant issue. In fact, its prevalence was so severe that physicians were initially looking for other explanations.

“A lot of what we thought about previously as being severe asthma actually ends up being asthma that is difficult to treat because of these issues in the way patients have been taking their medications — not only in terms of their inhaler technique, but also in terms of their adherence,” Bose said.

Bose advocates for partnerships with nurses and pharmacists to emphasize proper practice at the end of patient visits, and for physicians to also take it upon themselves to dissect the issue during their own check-ups. There’s a promising endgame for improved inhaler adherence and use.

“Our hope is that improved adherence and improved technique in their inhaler medications will lead to downstream affects in asthma control,” Bose said.