LAUSR

Introduction: In Chronic Obstructive Pulmonary Disease (COPD) inhalation medication plays a key role and correct inhalation technique is crucial. Aim: To evaluate a sample of COPD patients with respect to inhalation technique and the guidance provided by different test methods as well as the need for changing device/inhaler. Methods: In a pilot study we examined 54 COPD patients (30 males) with a mean age of 71.1 (49-92). 16 (29.6%) were newly referred. We collected clinical data (lung function, smoking status etc.). A COPD-nurse tested the inhalation technique: 1) In-checkTM Dial, 2) Turbohaler test-flute, AstraZeneca®, 3) Vitalograph AIMTM (Aerosol Inhalation Monitor), 4) Relevant placebo inhaler, and ended with a final inhaler recommendation - based on the test results. Results: 35.2% (n=19) of the patients demonstrated inspiratory flow ≤ 60 with In-checkTM Dial. 59.3% (n=32) demonstrated insufficient force and/or peak-velocity with the Turbohaler test-flute, AstraZeneca®. Among relevant cases, Vitalograph AIMTM demonstrated insufficient technique in 37 out of 88 (41.6%) with powder and soft mist whereas 0 out of 18 was evaluated to take spray correctly. Based on placebo devices only 37 out of 83 (44.6%) could demonstrate sufficient device handling skills. In total 55.6% (n=30) of the patients were changes in inhalation medication based on the tests. Conclusion: A surprisingly small amount of people treated for COPD were able to demonstrate adequate inhaler skills. There was no correlation between poor skills and being newly referred. More than half of the patients cannot use the inhaler they already have and needs to be changes.