Pulmonologist Education of the Teach-to-Goal Inhaler Technique for Those With Asthma and COPD

BACKGROUND: Inhaler education for patients with asthma and patients with COPD is typically provided by non-pulmonologists. We studied inhaler education by pulmonologists to determine changes in clinical outcomes and inhaler use.

METHODS: This was a retrospective study of 296 subjects diagnosed with asthma, COPD, or both that evaluated use of inhaler technique education and its impact on (1) inhaler/dosage change consisting of dosage change in the same class of inhaler and/or change in number of inhalers, (2) forced expiratory volume in one second/forced vital capacity (FEV₁/FVC%), (3) disease symptom control, (4) out-patient visits, (5) urgent care visits (6) emergency department visits, and (7) hospital admissions. One group received inhaler technique education by a pulmonologist while the other group did not.

RESULTS: The pulmonologist inhaler technique–educated group had significantly decreased relative risk for inhaler/dosage increase (relative risk 0.57 [95% CI 0.34–0.96], P = .03) and significantly increased odds for symptom control (odds ratio 2.15 [95% CI 1.24–3.74], P = .01) at 1-y follow-up as compared to the no education group. No differences occurred for FEV₁/FVC%, out-patient visits, urgent care visits, emergency department visits, and hospital admissions.

CONCLUSIONS: Pulmonologist education of inhaler technique for patients with asthma and patients with COPD was associated with decreased relative risk for inhaler/dosage increase and increased odds for symptom control. We recommend pulmonologists provide education of inhaler technique to patients with asthma and patients with COPD and not rely on non-pulmonologist education alone. Prospective research is needed to confirm the importance of proper inhaler techniques.