The parameters that may affect inhalation therapy success in elderly COPD and asthma patients

Introduction-Objective: One of the most important problems about treatment of elderly patients with COPD or asthma is mistakes in using inhaler devices. The purpose of this study was to assess the parameters affecting inhaler using success and treatment adherence. Method: COPD/asthma outpatients over age of 65 were included.Spirometry,Mini mental state test(MMST) for cognitive impairment and Morisky Medication Adherence Scale(MMAS) were performed.Data about usage of inhaler devices was collected by a 10-questioned test for inhaler device tecnique. Results: 121 patients (88 with COPD,33 with asthma),with the mean age of 70.41±5.52 were included.Breath out before and after inhalation of the medicine in was the most common mistake. Shaking the inhaler in metered dose inhaler(MDI),holding breath after inhalation of the medicine were other common mistakes.The patients with cognitive impairment, low socioeconomical status, emergency department application because of asthma/COPD in last year,presence of dyspnea or sputum had significantly lower inhalation device using scores(p=0.017, 0.03, 0.025, 0.03 and 0.02).The patients with high MMST scores and FEV1,as liter and percentage,were more successful in using inhaler devices(p=0.005, 0.007 and 0.022). Conclusions: The rate of mistakes in using inhaler devices in elderly patients with COPD or asthma was high.Cognitive dysfunction may be an important parameter that can affect inhalation device tecnique.Socioeconomical status,smoking, pulmonary symptoms and hospital applications because of airway disease were also thought to have effects on the adherence to inhalation therapy.