Inhaler Technique in Low-Income, Inner-City Adults with Uncontrolled Asthma

Abstract Background Poor inhaler technique has been shown to be associated with less asthma control and increased healthcare utilization. Little is known about the impact of inhaler technique on the most vulnerable patients. Objective This study examined inhaler technique in low-income, inner-city adults with uncontrolled asthma. Methods Inhaler technique data and other patient characteristics were evaluated in adults drawn from two studies conducted at the University of Pennsylvania. Subjects were from low-income Philadelphia neighborhoods and had uncontrolled asthma. Baseline characteristics were collected. Inhaler technique was rated by research coordinators who were trained with written materials. Results In 584 adults, 56% of metered dose inhaler (MDI) users and 64% of dry powder inhaler (DPI) users had adequate visually-assessed inhaler technique. Inhaler technique did not vary by reading comprehension or numeracy levels. Conclusion In this group of patients with uncontrolled asthma, visually-assessed inhaler technique was adequate in more than one-half. While incorrect inhaler technique is generally common and must be routinely addressed, this study suggests that other factors that lead to poor control must be identified.