Research reveals 90% of Aussie Asthmatics Use Their Inhalers Incorrectly

Most of Australia’s two million asthmatics are using their inhalers incorrectly, damaging their health and hitting the country in the hip pocket, specialists warn.

Research shows an alarming 90% of Australians with the chronic lung disease are not using their key medication correctly, either holding it inaccurately, inhaling at the wrong time, or using old, broken or empty devices.

Associate Professor Sinthia Bosnic-Anticevich, a researcher at Woolcock Institute of Medical Research, says inhalers are widely used among the two million Australians with asthma.

“Used correctly, inhalers have the power to effectively manage even persistent asthma but the problem is a worrying number don’t use them correctly even though they believe they are,” Associate Professor Bosnic-Anticevich says. “In many cases there’s been decades of incorrect use, simply because the person has never been shown how to do it properly.”

International research indicates between 30 and 80 per cent of inhaler users use the device incorrectly. Woolcock Institute research however puts the Australian figure at 90 per cent, a significant differential.

The research centre is sending a message to the medical fraternity stressing the importance of training Australian asthmatics on how to use their medication. It asks doctors and pharmacists to offer a few minutes of simple inhaler technique education to each patient.

“Talking about it is not enough,” says Associate Professor Bosnic-Anticevich, a leading authority on asthma inhaler use.

“Physical demonstrations are needed with a placebo inhaler to ensure that they really understand. Without it, a patient will not be getting the full benefit of their medications and this is extremely important with regards to controlling their asthma.”

Studies have shown that improving inhaler technique can improve asthma control and reduce symptoms. A report prepared for the National Asthma Council in 2008 investigated the problem, revealing many people, particularly those who were elderly, sick, cognitively-impaired and poorly educated, were using their devices incorrectly. Common issues included holding it the wrong way, inhaling too early or too late or using an inhaler that was either empty or faulty.

Associate Professor Helen Reddel, a respiratory physician at the Sydney-based institute, said inhaler use had not improved in the past five years. In fact, recent international research only serves to confirm the dire impact of incorrect device use on health. “The cost is not just on the individual either,” Associate Professor Reddel says. “The government foots huge medical costs to pay for these medications which are not being used correctly.”

She said the new Australian Asthma Handbook, due to be launched in March, will have a much greater emphasis on inhaler technique than ever before, to help tackle the problem.

Inhalers in Australia 

• Two million Australians – about one in ten – have asthma
• Asthma is a chronic lung condition that inflames and narrows the airways, causing wheezing, shortness of breath, chest tightness and coughing
• Many asthmatics manage their condition with an inhaled corticosteroid, as well as a reliever inhaler
• These medications cost more than $300m in direct health expenditure each year
• Evidence shows a high proportion of asthmatics don’t use their inhaler correctly. Rates of poor use are highest among the elderly
• Problems include positioning, timing of inhalation, and failure to recognise problems with the device
• Asthma researchers are urging doctors and pharmacists to watch their patients using their inhalers, and to physically demonstrate how to use the devices. Talking is not enough
• The forthcoming Australian Asthma Handbook will stress the importance of technique to better manage the condition
• Helen Reddel of the Woolcock Institute of Medical Research says that in clinical practice, improving inhaler technique can be as effective as increasing medication dose

(Source: Woolcock)