Initial findings from the C.H.O.I.C.E. national survey suggest that many asthma patients do not have their asthma under control and fall short of national treatment goals. Inhalers are the primary method for delivering asthma treatment. Patient knowledge, practice and health care providers’ perceptions regarding use of asthma inhalers were examined.
A cross-sectional phone survey was developed by a faculty of asthma specialists to understand the current state of asthma management in America. Asthma patients (N = 1,000; ≥12 years) were randomly identified from mailed surveys of households with self-reported asthma sufferers. Asthma patients were asked about their knowledge, attitudes, and behaviors regarding asthma treatment. Patients who had used a metered-dose inhaler (MDI) in the past 4 weeks were asked seven questions about inhaler technique. 500 health care providers (allergists, pulmonologists, family practitioners, nurse practitioners, physician assistants, pharmacists) were asked about asthma management and perceptions on patients’ use of inhalers.
Of asthma patients surveyed, 74% had used an inhaler to receive their asthma medication in the past 4 weeks. Almost all patients (90%) reported confidence in knowing how to use their inhaler correctly each time. However, only 5% correctly answered 7/7 questions about MDI use; 2% answered 0/7 questions correctly. On average, patients correctly answered 4/7 questions. Furthermore, 23% of patients reported occasional difficulty in breathing in from the inhaler, and others reported sometimes seeing a mist coming out of their mouths after inhaler use. 6%–15% of health care providers estimated that 91%–100% of patients used their inhalers correctly each time.
These findings suggest that patients’ understanding of proper inhaler technique is poor and may be one factor of many causing variability of dosing and posing a barrier to effective asthma management.
Improper use of inhalers may contribute to variable delivery of asthma medication, and accordingly less than optimal control. Increased awareness and a focus on training, testing patients on the use of their current inhalers are needed to optimize asthma management.
David Geller, Consultant fee, speaker bureau, advisory committee, etc. Teva Pharmaceuticals, Map Pharmaceuticals; No Product/Research Disclosure Information