To review the main types of hand-held inhaler available, together with current understanding about the correct inhalation techniques for each device.
To discuss problems that can lead to poor inhaler techniques, which in turn could contribute to poor asthma control.
To present recommendations of the Aerosol Drug Management Improvement Team (ADMIT) for inhaler selection, as well as an algorithm for asthma therapy adjustment.
Summary Asthma remains a poorly controlled disease, despite the availability of management guidelines and effective medications. The incorrect use of inhalers contributes to a lack of asthma control. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Dry powder inhalers (DPIs) are easier to use than pMDIs, as they are breath-actuated. The rationale behind inhaler choice should be evidence based, rather than empirical. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.
- ©ERS 2008