Health care professionals’ understanding of the use of a metered-dose inhaler

Abstract

We read with interest the letter by Bonds et al [1] Bonds R.S. Asawa A. Ghazi A.I. Misuse of medical devices: a persistent problem in self-management of asthma and allergic disease. Ann Allergy Asthma Immunol. 2015; 114: 74-76.e2 Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar on the misuse of inhalational devices for asthma and anaphylaxis among patients in Texas. From an asthma standpoint, the problems with the use of a pressurized metered-dose inhaler (pMDI) include inability to coordinate inhalation with actuation, inadequate breath hold, fast inspiratory flow rate, hand strength, and ideomotor dyspraxia. Although swapping inhalers or the use of a spacer can help, proper education of patients is needed to improve technique. Studies have found a lack of knowledge of correct MDI use among health care professionals (HCPs), 2 Interiano B. Guntupalli K.K. Metered-dose inhalers: do health care providers know what to teach?. Arch Intern Med. 1993; 153: 81-85 Crossref PubMed Scopus (111) Google Scholar , 3 Jones J.S. Holstege C.P. Riekse R. White L. Bergquist T. Metered-dose inhalers: do emergency health care providers know what to teach?. Ann Emerg Med. 1995; 26: 308-311 Abstract Full Text Full Text PDF PubMed Scopus (55) Google Scholar , 4 Kesten S. Zive K. Chapman K.R. Pharmacist knowledge and ability to use inhaled medication delivery systems. Chest. 1993; 104: 1737-1742 Crossref PubMed Scopus (95) Google Scholar which compounds the problem. We undertook a survey of pMDI technique among HCPs. Misuse of medical devices: a persistent problem in self-management of asthma and allergic diseaseAnnals of Allergy, Asthma & ImmunologyVol. 114Issue 1PreviewAnaphylaxis is a concerning disorder because of its life-threatening potential and increasing incidence. It is well established that intramuscular epinephrine is a life-saving therapy in anaphylaxis; however, patients frequently do not understand how to self-administer the medication. The problem of incorrect epinephrine autoinjector use is documented in the literature with rates of correct use as low as 22%.1,2 This misuse has been documented in cases of fatal anaphylaxis.3 Furthermore, health care professionals also lack knowledge of correct autoinjector technique. Full-Text PDF Authors’ responseAnnals of Allergy, Asthma & ImmunologyVol. 114Issue 6PreviewWe thank the authors for submitting their commentary on our article. The authors found, similar to our study and others, that most people were unable to use the inhalation device correctly on initial attempt. The number of patients who could demonstrate correct use has varied from 5.7% to 38% in previous reports.1,2 When studies have focused specifically on health care professionals, as the current one does, the numbers have increased to 5% to 69%, depending on the group examined.3 The current report is particularly interesting because of the use of a device that objectively measures performance of each user: the Aerosol Inhalation Monitor (Vitalograph AIM). Full-Text PDF