Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma

Figures & data

Figure 1. Particle deposition in the respiratory tract.

Adapted with permission from [48].

Figure 2. Asthma therapy adjustment flow chart.

Adapted with permission from [3].

Table 1. Resistance of dry powder inhaler devices.

Device	Mean (CV) resistance (cm H2O)^0.5 l/min	Inhalation flow (l/min) for an inspiratory effort corresponding to a pressure drop of 4 kPa across the device	Ref.
Accuhaler^®	0.078 (0.32)	82.4	[20]
Easyhaler^®	0.155 (0.21)	41.2	[62]
HandiHaler^®	0.158 (5.88)	40.4	[20]
Turbohaler^®	0.110 (0.50)	58.3	[20]

Table 2. Suitability of inhaler devices according to the patient’s inspiratory flow and ability to coordinate inhaler actuation and inhalation.

Good actuation–inhalation coordination		Poor actuation–inhalation coordination
Inspiratory flow		Inspiratory flow
>30 l/min	<30 l/min	>30 l/min	< 30 l/min
pMDI BA-MDI DPI Nebulizer SMI	pMDI Nebulizer	pMDI + spacer BA-MDI DPI Nebulizer SMI	pMDI + spacer Nebulizer SMI

Adapted with permission from [53].

Table 3. Inhaler devices that can be mimicked by the In-Check Device^®.

Device	Clinically effective inspiratory flow
Accuhaler^®	30–90 l/min^†
Autohaler^®	30–60 l/min^†
Clickhaler^®	15–60 l/min^†
Easi-Breathe^®	20–60 l/min^†
HandiHaler^® (using adapter)	20–60 l/min^‡
pMDI	25–60 l/min^†
Turbohaler^®	30–90 l/min^†

^†Data taken from from Clement Clarke Ltd, UK.

^‡Data taken from [63].

Activity Evaluation: Where 1 is strongly disagree and 5 is strongly agree

	1	2	3	4	5
1. The activity supported the learning objectives.
2. The material was organized clearly for learning to occur.
3. The content learned from this activity will impact my practice.
4. The activity was presented objectively and free of commercial bias.

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