Inhaler device handling: have we really started to address the problem?

How big a problem is inhaler technique and how important is it? In this issue of the European Respiratory Journal we are presented with a “real-life” study exploring the inhaler technique of almost 3000 patients with chronic obstructive pulmonary disease (COPD) and the relationship between inhaler device handling and disease control. This observational, cross-sectional study, conducted by Molimard et al. [1], assesses the handling of devices by patients visiting general practitioners and pulmonologists and in so doing determines two key findings. 1) Over 50% of patients with COPD are not able to use their devices correctly. 2) Patients making “critical errors” in their device handling are two-times more likely to experience severe COPD exacerbations than those not making critical errors (3.3% versus 6.9% in the previous 3 months, respectively, OR 1.86). Let's consider again: how big a problem is inhaler technique and how important is it?