Allergy Asthma Immunol Res.  2011 Jan;3(1):46-52. 10.4168/aair.2011.3.1.46.

Skills in Handling Turbuhaler, Diskus, and Pressurized Metered-Dose Inhaler in Korean Asthmatic Patients

Affiliations
  • 1Armed Forces Capital Hospital, Seongnam, Korea.
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 3Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.
  • 4Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
  • 6Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea.
  • 9Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 10Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
  • 11Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 12Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. ykjee@dankook.ac.kr

Abstract

PURPOSE
The objective of this study was to evaluate skills in handling inhalers and factors associated with these skills among patients with asthma who had undergone treatment at special asthma and allergy clinics in Korea.
METHODS
We enrolled 78 subjects who used Turbuhaler and 145 who used Diskus for asthma control at special clinics in 10 university hospitals and visually assessed their skills in handling these inhalers. We also evaluated skills in 137 subjects who had used pressurized metered-dose inhalers (pMDIs) for symptom relief. Age, sex, duration of asthma and inhaler use, smoking status, monthly income, highest grade completed in school and previous instruction for handling inhalers were also measured to evaluate their association with overall inhaler skills.
RESULTS
Performance grade was inadequate for 12.8% of participants using Turbuhaler, 6.2% for Diskus, and 23.4% for pMDIs. The success rates for each step in handling the inhalers were relatively high except for the "exhale slowly to residual volume" step, in which success rates ranged from 24.2% to 28.5%. Older age, male sex, lower educational grade, and absence of previous instruction for handling inhalers were associated with inadequate inhaler technique in univariate analysis; however, only older age and absence of previous instruction remained significant independent risk factors in multivariate analysis.
CONCLUSIONS
Among Korean asthmatic patients in special asthma and allergy clinics, skills in handling their inhalers were mostly excellent; meanwhile, older age and absence of previous instruction for handling inhalers were associated with inadequate techniques.

Keyword

Asthma; Turbuhaler; Diskus; metered-dose inhaler
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