Introduction: Incorrect inhaler technique is a major contributor to poor disease control in chronic respiratory diseases, particularly in low- and middle-income countries where therapeutic optimization is crucial. Studies report incorrect technique in up to 40–80% of patients, leading to poor drug deposition and increased exacerbations. This study assessed inhaler techniques across different device types among patients with chronic obstructive pulmonary disease. Methods: A hospital-based descriptive cross-sectional study was conducted among 500 adult patients using dry powder inhalers or metered-dose inhalers with or without spacers. Technique was evaluated using a standardized stepwise checklist through direct observation. Categorical variables were expressed as frequencies and percentages. Results: Of the 500 participants, 298 (59.60%) used DPIs, 202 (40.40%) used metered dose inhalers, of whom 40 (20% of Metered dose inhalers users; 8% of total participants) used a spacer. Among dry powder inhaler users, correct performance was observed in 50% for deep inhalation and 45% for breath-holding. In Metered dose inhalers users without spacers, coordination between actuation and inhalation was correct in 29%, slow deep inhalation in 27%, and breath-holding in 25%. Metered dose inhalers use with spacers showed better performance, with correct inhalation in 68% and breath-holding in 60%. Critical inhalation steps showed the low correctness across all devices. Spacer improved performance but did not eliminate inhalation-related errors, highlighting the importance of targeted training. Conclusions: This study shows that patients using both MDIs and DPIs still frequently use inhalers incorrectly, with the most serious mistakes happening during the inhalation phase.
Bam et al. (Sat,) studied this question.
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