Journal Article


Richard W Costello
Richard B Reilly
Sheila A Ryder
Susan O'Dwyer
Mazen Al-Alawi
Gerard Bury
John Casey
Katrina McCrory
Fiona Boland
Shona D'Arcy
and 3 others


Medicine & Nursing

observational study time use quantitative cross sectional studies community pharmacies twenty one primary care community care

Irregular and Ineffective: A Quantitative Observational Study of the Time and Technique of Inhaler Use. (2016)

Abstract Cross-sectional observational studies suggest that between 50% and 60% of patients misuse a dry powder inhaler, whereas studies with electronic monitors indicate that patients sometimes overuse/underuse their inhalers. It is not known what impact errors and erratic use have on inhaler adherence. The purpose of this study was to longitudinally quantify when and how patients adhered to a twice-daily preventer treatment by using a novel acoustic recording deviceĀ attached to an inhaler (INhaler Compliance Assessment). Patients with a history of asthma or chronic obstructive pulmonary disease (nĀ = 123) from primary care and community pharmacies were given an INhaler Compliance Assessment-adapted inhaler for 1 month. Analysis of the audio files provided quantitative information on time and technique of inhaler use. Data were available for 103 patients. Twenty-one patients (20%) used their inhaler in the correct manner at the correct interval. There were 5045 audio files with attempted inhalations, of which 1204 had technique errors (24%). Errors included inadequate flow (27%), drug priming without inhalation (19%), exhalation into the inhaler (18%), and multiple inhalations (25%). On average, participants made errors 20% of the time. Of 60 doses expected to be taken in a month per person, on average 49 doses (82%) were attempted and when errors were accounted for, the average number of actual doses taken was 34 doses (57%; P < .01) comparing attempted to actual doses. These data highlight that ineffective and irregular inhaler use is common and when combined in a single calculation indicate that only 20% of participants used their inhaler correctly and on time.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed

Full list of authors on original publication

Richard W Costello, Richard B Reilly, Sheila A Ryder, Susan O'Dwyer, Mazen Al-Alawi, Gerard Bury, John Casey, Katrina McCrory, Fiona Boland, Shona D'Arcy and 3 others

Experts in our system

Richard W Costello
Royal College of Surgeons in Ireland
Total Publications: 62
Richard Reilly
Trinity College Dublin
Total Publications: 183
Sheila A Ryder
Royal College of Surgeons in Ireland
Total Publications: 5
Susan M O'Dwyer
Royal College of Surgeons in Ireland
Total Publications: 4
Gerard Bury
University College Dublin
Total Publications: 84
Fiona Boland
Royal College of Surgeons in Ireland
Total Publications: 44
Shona D'Arcy
Royal College of Surgeons in Ireland
Total Publications: 12