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Respir Care. 2017 Jul;62(7):882-887. doi: 10.4187/respcare.05246. Epub 2017 Mar 28.

Evaluation of the Prevalence and Effectiveness of Education on Metered-Dose Inhaler Technique.

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Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.
Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.



The objectives of this study were: (1) to assess the prevalence of and types of education methods provided to participants who use a metered-dose inhaler (MDI), (2) to determine the prevalence of MDI misuse in adults using objective and subjective assessments, and (3) to determine whether any associations exist between the education method and the participant's ability to properly use an MDI.


Adult participants who had a current or previous history of MDI use were recruited from retail pharmacies and physician offices in Laurens County, South Carolina. Exclusion criteria included the use of an MDI spacer, inability to speak/understand English, or current acute respiratory illness. Participants completed a survey regarding inhaler use and previous education, a subjective checklist assessment by demonstrating use of an MDI, and an objective assessment by using the Aerosol Inhalation Monitor (AIM).


Of 100 participants, 25% reported never having received education about inhaler technique, and 94% were found to have insufficient MDI technique. No association between the method of education and successful MDI technique with the AIM was identified (P = .31). Participants were less likely to correctly use the AIM if they missed >3 steps in the subjective assessment. (P = .032).


Although most participants received inhaler education, inhaler misuse was very common. No associations were found regarding method of education and proper inhaler technique.


MDI education; MDI technique; Vitalograph AIM; metered-dose inhaler (MDI); misuse; objective assessment

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