Assessment of proper use of Metered Dose Inhaler among patients attending the Out Patient Department of Respiratory Medicine: a cross sectional study

Abstract

Introduction
Respiratory inhalers are the backbone of asthma and COPDmanagement, targeting drug delivery directly to the airways
(target zone).However, inhalers are very often used sub-optimally leading to uncontrolled symptoms and increased drug
utilization for relief medication or preventative therapy, thereby increasing the prescription costs for patients.
Objectives:
Tofind out the socio demographic profile,disease characteristics, type of MDI used and assessing the correct stepsof
usage of MDI among patients, attending Respiratory Medicine Outpatient Department of Nil Ratan Sircar Medical College,
Kolkata.
Materials and methods:
An institutional based observational descriptive study with cross sectional design, was carried out, among 115 patients
using MDI,>12 years attending respiratory OPD during the study period were included in the study. Data were collected
using a predesigned and pretested schedule, entered into MS excel, cleaned and analysed with SPSS (IBM SPSS version
20). Approval was taken from Institutional Ethics Committee.
Results
The mean (standard deviation) age of the study population was 50 (14.5) years. Almost 53%(52.2%) of the patients were
using steroid inhalers, 47.2 % of them for > 12 months. Most (93%) had been demonstrated by the treating physician. Only
13% perceived difficulty in MDI use. The common mistakes made by the patients during MDI use were the following;
13.9% sealed the mouth around the inhaler, 29.6% continued breathing after pressing the MDI and 38.3% rinsed their
mouth after using steroid inhaler.
Conclusions
Several mistakes are committed by the users of MDI during the process, almost all of which can be minimized by repeated
instructions and supervision of MDI technique by the treating physician. Proper MDI use will decrease drug wastage
leading to better and cheaper management of symptoms.