LAUSR

Objective: To evaluate rate and type of errors in inhalation technique of patients seen in hospitals at the observation area in the  emergency department, as well as patients seen in the outpatients clinic  at the primary care pharmaceutical consultation, and at the  community pharmacy. Method: Descriptive observational study carried out by a hospital  pharmacist, along with a primary care pharmacist and a community  pharmacist. An anonymous survey was performed in order to collect  different analyzed data. Each patient was asked to execute a complete  demonstration on how they used their inhalers, to actively check the  inhalation technique. Two checklists regarding the type of inhaler were  established in order to assess said technique. Results were tabulated  through Microsoft Excel® 2010 software and analyzed through R 3.5  statistical program. Results: A total of 66 patients (42 male, 24 female; mean age 67) were  recruited. Out of all patients, 48.5% used more than one  inhaler, which 34.4% used different types of inhaler, and 65.6% used  different systems. A total of 39 patients were under dry powder inhaler  therapy, and 38 were using pressurized metered dose inhalers. The  most frequent errors –both in dry powder inhalers and pressurized  metered dose inhalers–were: not performing a 10 second apnea and not  slowly expelling air from the lungs. Around 50% of patients needed  new learning after assessing their inhalation technique, even though  88.5% had already received previous training. Older aged patients  performed a worse inhalation technique. Conclusions: There is a high rate of errors in the use of inhaled  therapy, being even higher among older aged patients. The inhalation  technique training by the medical staff seems inadequate, as it is crucial  to raise awareness about the importance of health education for  patients and their use of inhalers, to which a scheduled follow up and a  technical and feedback obtained from the patient assessment is  required.