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Wrong inhalation technique is associated to poor asthma clinical outcomes. Is there room for improvement?

Román-Rodríguez, Miguela,b; Metting, Estherb; Gacía-Pardo, Marinaa; Kocks, Janwillemc,d; van der Molen, Thysb

Current Opinion in Pulmonary Medicine: January 2019 - Volume 25 - Issue 1 - p 18–26
doi: 10.1097/MCP.0000000000000540
ASTHMA: Edited by Nicola A. Hanania and Zuzana Diamant

Purpose of review The long-term goals of asthma management are to control symptoms and to reduce the risk of exacerbations. Inhaled medication is the cornerstone of pharmacological treatment for asthma; therefore, good inhalation technique is the key for asthma management. However, up to 70% of asthma patients do not use their inhalers correctly. There is evidence on how poor inhalation technique is associated to poor asthma control. The purpose of this review is to present the most recent research in this field to help clinicians understand the importance of proper inhalers use and the possible interventions to optimize patients’ inhalation technique.

Recent findings New evidence on how poor inhaler technique and specific critical errors are significantly associated to poor asthma control and exacerbations and how this negative impact could be improved by optimizing device selection, enhancing shared decision-making and giving more importance to education, both for patients and healthcare professionals. New devices and additional tools might help patients to achieve the correct inhaler technique and could form the basis of simplified educational interventions.

Summary There is an urgent need for specific interventions including new educational strategies to minimize the negative effects of wrong inhalation technique in asthma clinical outcomes.

aPrimary Care Respiratory Research Unit, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma, Spain

bDepartment of General Practice and GRIAG Research Institute, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

cGeneral Practitioners Research Institute, Groningen, the Netherlands

dObservational and Pragmatic Research Institute, Singapore, Singapore

Correspondence to Miguel Román-Rodríguez, MD, Centro de salud Son Pisa, C/Vicente Joan Rossello 65, Palma 07011, Baleares, Spain. Tel/. fax: +34 971 293566; e-mail:

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