Abstract
Background: Correct inhalation technique is crucial for asthma therapy delivery. Incorrect technique could influence patient outcomes.
Aim:To investigate inhaler technique with patient characteristics and outcomes in real-life primary care setting.
Methods:Retrospective,cross sectional study using international iHARP database including electronic patient records and questionnaires from 8 countries. Asthma patients (GINA step 3-4) performing no errors were compared with those performing ≥1 error using Mann-Whitney test for numerical and Χ2 test for categorical variables. Errors were defined by iHARP steering committee and recorded by qualified nurses from 2011-2013.
Results: Of 3681 patients, 623 (17%) used Diskus (67% female; median age 52 [IQR:41-63]). 55% of those performed ≥1 error. Female and obese patients performed more errors (p=0.024,p=0.036 respectively). 26% of patients with ≥1 error had uncontrolled GINA-defined asthma vs. 17% of patients having no errors (p=0.017). Similar association observed for ATAQ score (p=0.003). 19% in the ≥ 1 error and 10% in the no error group had ≥ 1 annual in-patient admission/A&E attendance(p=0.001). Error and exacerbation risk association is shown below.
Conclusion: Asthma patient inhaler technique remains poor and is associated with poor asthma control,and higher hospitalisation and exacerbation risk. Obese and female patients are most at risk.
- © 2014 ERS