Potential benefit of repeated MDI inhalation technique counselling for patients with asthma

Objectives The aim of this study was to examine the effect of metered dose inhaler (MDI) counselling on the inhalation technique and pulmonary function test scores of patients with asthma. Methods 491 subjects with asthma (281 female) attending the Beni Suef University hospital outpatient clinics were enrolled during a 2-year period. Their mean (SD) age was 42.1 (17.1)years. Their MDI inhalation technique was checked and the number of mistakes was noted and corrected at the first visit and at each of two following monthly visits (three visits in total). Their peak expiratory flow and forced expiratory volume in 1s (FEV1) as a percentage of the forced vital capacity were checked at each visit. Results Most MDIs contained salbutamol, although some patients were using MDIs containing beclomethasone or a combination of beclomethasone and salbutamol. The mean number of mistakes observed decreased significantly (p<0.001) as the number of visits increased, especially in the children's group. The most common repeated mistake was failure to maintain a slow inhalation rate until the lungs were full. There was a significant improvement (p<0.001) in pulmonary function test scores after counselling in all age groups, particularly in those aged >60years. Conclusions MDI counselling should be frequently repeated to improve and maintain the recommended MDI inhalation technique and possibly improve patients' pulmonary function tests scores.