Background: Multi-dose dry-powder inhalers are
perceived as being easier for patients to use than conventional
pressurized aerosol inhalers; however, no study has determined whether
patients handle such devices adequately and whether there is a need for
patient education in this area.
Method: We used
trained observers to assess the handling of a specific multi-dose dry
powder inhaler (Turbuhaler; AstraZeneca Canada; Mississauga, ON) by
patients currently using the device for the management of their asthma.
Fourteen discrete steps were scored independently by two observers
simultaneously. Patients were divided into two groups for analysis:
those who had received formal instruction in the use of the inhaler at
The Asthma Centre and those who had received no formal instruction in
Results: There was no significant
difference between the formally trained groups and control groups in
the percentage of handling steps performed correctly (79% vs 78%,
respectively; p > 0.05). Fewer than 50% of patients in both groups
demonstrated optimal breath-holding when using the device.
Conclusion: Patient handling of Turbuhaler was generally
good, with no evidence that a structured education intervention offered
an advantage over the usual education incidental to the prescribing or
dispensing process. The most common handling flaw, suboptimal
breath-holding, is not specific to this device and is of uncertain