Background When using an inhaler for asthma or chronic obstructive pulmonary disease, the correct inhalation technique is essential for obtaining the desired effect. However, the development of different types of inhalers has led to inhalation techniques that differ greatly among devices. Therefore, we prepared the ‘Unified Inhalation Guidance Documents’ (UIGDs) in cooperation with hospitals and pharmacies in our region for each available type of inhaler.

Purpose To assess the benefits and problems of the UIGD.

Materials and Methods A total of 165 Japanese patients who received inhalation therapy from June 2011 to September 2012 were enrolled, and 213 points regarding the inhalation technique with 8 types of inhalers were obtained. The inhalation technique of patients who received guidance based on the UIGD for the use of inhalers was assessed by scoring inhalation skill. In addition, we assessed the impact of age on the acquisition of inhalation technique.

Results We found that 86 cases (40.4%) showed problems with inhalation technique. In particular, patients using a Breezhaler (4/5) and Turbuhaler (18/37) had a high rate of problems with their technique. Problems were more frequent in patients aged 65 or over (older) (63/146, 43.2%) compared with other patients (younger) (23/67, 34.3%). In particular, for patients using a Turbuhaler, more older patients (10/14, 71.4%) than younger patients (8/23, 34.8%) had trouble with technique.

Conclusions Around 40% of patients who received guidance based on the UIGD for the use of inhaler devices had trouble with their inhalation technique. Therefore, the UIGDs for the Breezhaler and Turbuhaler should be reassessed. Because the use of some types of inhalers was difficult for older patients, developing an inhaler and guidance specifically for older patients should be considered.

No conflict of interest.