Abstract

Identification of poor inhaler technique is vital for COPD management at time of hospital discharge and thereafter. This observational study aimed to determine the impact of exacerbation on the errors of inhaler techniques among COPD patients. The study was conducted in chest clinic at Central Chest Institute of Thailand. Patients having diagnosed of COPD for at least 1 year, treated with inhalation devices and attained inhaler technique training were eligible for study. Demographic and clinical characteristics were obtained and inhaler techniques were assessed. The error was classified as critical or noncritical regarding medication reaching the lungs. Of 143 patients, 27 had history of exacerbation. The median inhaler devices per patients were 2 similarly in both groups. The proportion of patients performing at least 1 critical error was significantly lower in those having history of exacerbation and using pMDI without spacer (p=0.020) while the proportion of patients performing at least 1 error was significantly higher in those with history of exacerbation (p=0.014). History of exacerbation has no impact on inhaler technique except MDI without spacer. Inhaler technique training and assessment are strongly recommended to continue to sustain proper inhaler technique as well as increase quality of life and economic benefits.

Key words: inhaler technique, COPD, exacerbation, critical error