Impact of short training of inhalation technique on the course of asthma and COPD

Abstract

Introduction: A significant number of patients with asthma and COPD do not use inhalers properly. Improper inhaler use may result in poor disease control. Aim: To determine the efficacy of a short training of inhaler use on the course of asthma or COPD. Material and Methods: Adults with asthma or COPD who used at least one inhaler on a regular basis were included. The patients were randomized to a single short training of inhalation technique (STIT) or control (C). The control patients were educated, but their inhalation technique was not corrected. Symptoms severity, number of exacerbations, quality of life (measured by AQLQ or SGRQ) and number of mistakes in inhalation technique were analyzed. The efficacy of training was checked after 3 and 6 months. The outcome measures were compared between STIT and C groups, as well as within groups, i.e. before and after intervention. Results: Of the 100 patients enrolled, 90 (90%) completed the study (asthma – 45 patients, COPD – 45 patients). Of these, 47 patients were randomized to intervention, while 43 were controls. The reduction in number of mistakes made during inhalation was found in 52/90 (58%) subjects. Smaller percentage of educated patients made mistakes during inhalation than controls (32/47 vs 20/43, p=0.0385). The relative benefit was 1.46 (95%CI 1.005 -2.131, p=0.046). NNT was 4.6 (95%CI 2.4-61). However, there was neither significant reduction in exacerbation rate and symptom control, nor significant improvement in quality of life. Conclusions: A short, single training of proper inhalation technique leads to a reduction of the number of mistakes made during inhalation, but it doesn’t influence the course of asthma or COPD.