Around 3.8 million people in the UK have not been instructed on how to use their inhalers correctly, according to new research. A survey by the charity Asthma + Lung UK revealed that approximately 70% of the UK's 5.4 million asthma sufferers—equating to 3.8 million individuals—do not receive the most basic elements of care, including guidance on how to optimise their inhaler use. This lack of education is believed to contribute to the four asthma-related deaths that occur daily in the UK, many of which are considered preventable.
New Guide Issued by UK Inhaler Group
The findings, along with ongoing issues surrounding inhaler technique, have prompted the UK Inhaler Group (UKIG) to release a new guide aimed at better educating patients on the effective use of these life-saving devices. To promote the guide, Dr Katherine Hickman, a GP and respiratory specialist, shared several tips for ensuring correct usage.
Check if You Should Use a Spacer
The NHS states that spacers are 'more effective' at delivering medication to users of pressurised metered-dose inhalers (pMDIs), which account for around 70% of inhalers in the UK. Spacers hold the medication after it leaves the inhaler, making inhalation easier. For pMDI users, a study published in the European Respiratory Journal found that not using a spacer can result in as little as half the intended dose being delivered. 'Spacer devices play a critical role in asthma care, mitigating technique, coordination and throat deposition issues, which we know impact both adults and children,' Dr Hickman said. 'We need to spread the message about spacer use as far and wide as possible.' However, spacers are not suitable for all inhaler types; dry powder inhalers (DPIs) and breath-actuated inhalers (BAIs) do not require a spacer, according to Asthma + Lung UK. Patients should consult their GP or pharmacist to determine if a spacer is appropriate.
Shake the Inhaler
It is essential to shake the inhaler well before each use to ensure the medication is properly mixed and each puff delivers the correct dose, explained Liam Clutterbuck from Trudell Medical UK. Failing to do so can result in uneven distribution of the medicine, reducing its effectiveness. The NHS recommends waiting approximately 30 to 60 seconds between puffs and shaking the inhaler each time to help ensure the correct dose is received.
Inhale Slowly and Deeply
Exhale fully first, then inhale in a steady, calm breath over 3 to 5 seconds, rather than taking a fast, sharp breath, Liam advised. A slow, steady breath allows more time for the medicine to travel deep into the lungs, where it is needed, rather than being deposited in the mouth or throat. Asthma + Lung UK also recommends holding the breath for around five to 10 seconds after inhaling the medication, where possible, to give the medicine time to settle in the airways.
Ensure a Tight Seal
Form an airtight seal around the mouthpiece or facemask so no medication can escape, Liam said. A poor seal can allow medicine to leak out, reducing the amount that reaches the airways and making the inhaler less effective. NHS guidance recommends breathing out fully before placing the inhaler or spacer in the mouth, then inhaling in one slow, steady breath to maximise delivery of the medication.
