First, get the basics right through demonstration and visual cues:
- Evidence suggests that the more actively patients engage with learning about their asthma medication, the more they will get out of it. Asking patients to demonstrate how they take their medication is more effective than showing them. Can patients film themselves on their mobile phone, or demonstrate online if not seen face-to-face?6
- Providing visual information such as videos and pictures is often more effective than verbal instruction, especially for patients who have low health literacy.7
- Repetition is also good. Providing support on multiple occasions and facilitating practice is likely to support patients to use their inhaler correctly from the start and to keep using it correctly over time.8
Next, consider the vicious cycle and address motivation.
- Even if someone is reviewed over the phone, the importance of inhaler technique can still be addressed through patient discussion, supplemented with extra online resources. For example, explaining what might happen if inhaler technique is poor. Or, if someone using a dry powder inhaler breathes in too slowly, their medication may not reach their lungs meaning they are still at risk of asthma exacerbations.
- Are there ways of demonstrating asthma inhaler technique that can help to normalise using an asthma inhaler and overcome feelings such as embarrassment about using inhalers in practice? For example, showing people taking asthma inhalers in public places rather than in private as part of the resource pack, or providing reassurance to patients as they demonstrate.
So, when thinking about demonstrating correct inhaler technique it might be important to look beyond initial behaviour, even when providing support outside of clinic.
1 Annual asthma survey | Asthma UK
2 GINA Main Report 2022 Front Cover (ginasthma.org)
3 Understanding Patient Perspectives on Medication Adherence in Asthma: A Targeted Review of Qualitative Studies - PMC (nih.gov)
4 Inhaler competence in asthma: Common errors, barriers to use and recommended solutions - ScienceDirect
5Interventions to improve inhaler technique for people with asthma - Fortescue, R - 2017 | Cochrane Library
6Effective behavior change techniques in asthma self-care interventions: Systematic review and meta-regression. - PsycNET (apa.org)
7Using pictures to convey health information: A systematic review and meta-analysis of the effects on patient and consumer health behaviors and outcomes - ScienceDirect
8Treatment perceptions in patients with asthma: Synthesis of factors influencing adherence - ScienceDirect