A shocking statistic that 94 per cent of Australians don’t use their asthma inhalers correctly has led to the development of an asthma inhaler resource that for the first time clearly address the two different types of inspiratory flow rate with inhalers.
The National Asthma Council Australia (NAC), in collaboration with the Pharmaceutical Society of Australia, has developed supplementary labels to be affixed to inhalers in addition to the dispensing label.
Associate Professor Debbie Rigby, an advance practice pharmacist and Clinical Executive Lead at the National Asthma Council Australia has led the push to support patients to know what the appropriate inspiratory flow rate is to ultimately get better outcomes for those with asthma and COPD.
“Optimal inhaler technique is critical to optimal disease outcomes and inspiratory flow rate is one of the most critical errors that patients can make.
“Inspiratory flow rate directly impacts on both the amount of drug that is inhaled as well as the lung deposition and therefore the outcome for people with respiratory conditions.
“There are numerous inhalers available in Australia and it can be extremely confusing, especially if people are on multiple different inhalers.
“They might be on a dry powder inhaler (DPI) as well as a pressurised metered dose inhaler (pMDI) and they have different inspiratory flow rates, which can be really challenging for people to remember.
“So when the pharmacist applies a supplementary label to the inhaler it acts as a prompt and a reminder when using their inhaler which way they should be breathing in,” said Associate Professor Rigby.
Associate Professor Rigby said that for pMDIs, breath-actuated pMDIs and soft mist inhalers (Respimat), the inspiratory flow rate requires the patient to inhale slow and steady over 3-5 seconds.
“If the patient breathes in quickly, a lot of the aerosol is impacted on the back of the mouth in the oropharyngeal area. By breathing slow and steady over 3-5 seconds, they will get a greater percentage going down into the lungs which is critical for optimal lung deposition.
“However, with the DPIs, it needs to be a quick and deep inhalation over 2-3 seconds because it is a powder. There are no propellants in DPIs and the active ingredient is mixed with lactose as an excipient. There is a need to separate the active ingredient from the lactose which needs a quick, forceful inhalation to help that deagglomeration of the active ingredient from the powder,” she said.
Associate Professor Rigby said pharmacists should be encouraged to assess and correct inhaler technique at every opportunity.
“APF26 has a new section on inhalers, detailing the steps for different types of inhalers and using these stickers may enable a different starting conversation with the patient and remind the patient of the correct inspiration techniques when they use their inhalers,” she said.
Asthma inhaler information cards are also available to help with appropriate selection of labels. A QR code on the card links to the NAC videos on inhaler technique. An additional sticker has also been created urging patients to return unused inhalers to the pharmacy for safe disposal, so they don't end up in landfill.
The stickers and cards are available to order online from Stirling Fildes. Pharmacies require a login to order these resources. Please visit the Stirling Fildes website to set up an account.
Read the full article for health professionals by Associate Professor Debbie Rigby, Clinical Executive Lead, National Asthma Council Australia.
For further information or an interview with a NAC spokesperson please contact: Donna Le Page, Le Page PR Mobile: 0429 825 703 Email: [email protected]
