Asthma is an inflammatory airway disease managed by medications which are delivered through inhalers. A new study published in Primary Care Respiratory Medicine showed that attaching personalized labels to inhalers promotes the use of proper technique and could lead to better health outcomes.
Asthma is a disease in which there is long-term inflammation in the airways of the lungs. Individuals with asthma typically have variable and recurring symptoms due to airflow obstruction including coughing, shortness of breath, and chest tightness. Individuals can experience symptoms from multiple times a day to only a few times per week depending on the severity of their case. The prevalence of asthma has been increasing in recent years, particularly in developing countries, increasing the need to better equip individuals to manage their symptoms.
Asthma is typically managed by medications delivered via inhalation by handheld inhaler devices. Two types of inhalers are typically used. The first is the pressurized metered dose inhaler (pMDI) which delivers a specific amount of medication to the lungs in aerosolized form. The second is the dry-powder inhaler (DPI) that delivers medication to the lungs in the form of a dry powder. DPIs are gaining popularity in older children and adults as they avoid coordination problems associated with pMDIs.
Patients using DPIs still need to follow proper inhaler technique to obtain optimal medicinal delivery. This includes preparing the device for inhalation and generating an inspiratory flow rate of at least 30L/min. Only 7-50% of individuals use correct inhaler technique, and improper technique has been associated with worse disease outcomes. Therefore, inhaler training is an important aspect of asthma education. Despite training, however, most patients fail to use proper technique within a few months of the training.
A new study published in Primary Care Respiratory Medicine examined the effect of inhaler technique labels on the retention of correct inhaler technique and asthma control. In this study, 99 patients were randomly assigned to either an active or control group. All patients received physical demonstration of inhaler technique, after which all patients had correct technique as measured by scoring. Following this, patients in the active group received personalized inhaler labels highlighting their initial errors and providing proper technique.
At a 3 month follow-up, patients in the active group had better inhaler technique scores than patients in the control group, demonstrating that written labels are an effective method to promote proper inhaler technique. Interestingly, symptoms did not differ significantly between the two groups.
A large limitation of this study is that patients were only followed up with after 3 months. A more striking difference in inhaler technique between active and control groups may be visible after longer periods of time when both groups have gone longer without physical training, as the written labels would serve more beneficial with more time passed. Additionally, changes in symptoms would likely not be evident within 3 months and a longer study would be beneficial.
In conclusion, this study showed that attaching personalized labels to the inhalers allows for better retention of correct technique. Labels are an inexpensive and feasible intervention that increases the efficiency of inhaler training, and could result in drastic improvements in asthma patients’ health outcomes.
Written By: Neeti Vashi, BSc