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BACKGROUND: Metered dose inhalers (MDIs) are commonly prescribed for inhalation therapy, but correct use is critical to promoting effective medication delivery. This systematic literature review and meta-analysis evaluates the overall and step-by-step prevalence of errors among adults with obstructive lung diseases in the United States who used MDIs. METHODS: statistic. RESULTS: Aggregate findings revealed that 86.7% of patients (n=390, 95% CI 77.5-96.0) made at least 1 inhalation technique error, and 76.9% (n=885, 95% CI 65.8-87.9) incorrectly performed ≥ 20% of device use steps. The most prevalent step-by-step errors across the studies (n=1105) were failure to: (a) exhale fully and away from the inhaler before inhalation (65.5% 95% CI 52.0, 78.9); (b) hold breath for 5-10 seconds (41.9% 95% CI 29.8, 53.9); (c) inhale slowly and deeply (39.4% 95% CI 26.2, 52.5); (d) exhale after inhalation (35.9% 95% CI 17.0, 54.8); and (e) shake the inhaler before use (34.2% 95% CI 30.6, 37.7). CONCLUSIONS: Across the studies used in this meta-analysis more than three-fourths of U.S. adults with obstructive lung diseases used MDIs incorrectly. Our findings suggest the need for ongoing patient education and consideration of alternative devices to mitigate errors.
Cho‐Reyes et al. (Tue,) studied this question.