Evaluation of Inhaler Techniques Among Asthma Patients Seen in Nigeria: An Observational Cross Sectional Study

Abstract

Background: An Adequate and an effective dose of inhalation drugs can be administered only if the correct inhaler‑specific technique is followed by asthma patients. There is paucity of data on this subject among Nigerians and Africans. Aims: This observational study was to assess the inhaler techniques among asthma patients in Nigeria and also to identify the factors related to an inaccurate or poor inhaler use. Subjects and Methods: Consenting asthma patients on inhalers, who attended medical out‑patients clinic, of two university hospitals in Nigeria were asked to use their inhalers while an inhaler‑administration  checklist was used to assess each patients inhaler technique. Information on demographics, asthma symptoms history and history of technique education were obtained. Data was analyzed using standard statistical methods. Results: A total of 140 asthma patients participated out of which 75 were females. All the patients used pressurized metered dose inhalers (pMDI) type; 51 of them used dry powder inhalers (DPI) in addition. For pMDI, 22.1% (31/140) completed all required steps while 37.3% (19/51) did so for DPI (P = 0.04). Patients with higher educational qualification (P < 0.01) and those with less frequent asthma symptoms (P < 0.01) are more likely to use the pMDI inhalers more accurately while patients who have been taught previously by a Doctor were more likely to use the DPI better. Conclusion: Majority of asthma patients use their inhalers inaccurately. Patient‑dependent factors were identified as the cause of incorrect technique of inhaler use. Asthma patients on inhalation medications should have routine assessment of their inhaler technique at every visit and corrected if found to be poor.

Keywords: Asthma, Dry powder inhalers, Inhaler‑administration checklist, Inhaler technique, Pressurized metered dose inhaler