SynthesisNPJ primary care respiratory medicine2017
Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review.
Synthesis in NPJ primary care respiratory medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 70 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Role of "Asthma School" in Disease Management
Study on the Effect of Precise Aerosol Inhalation Nursing Program on Effective Sputum Excretion in Elderly Patients With Lung Surgery
Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Home-based educational interventions for children with asthma.The Cochrane database of systematic reviews · 2025Pooled it
- Interventions to improve adherence to pharmacological therapy for chronic obstructive pulmonary disease (COPD).The Cochrane database of systematic reviews · 2021Pooled it
- Systematic review of association between critical errors in inhalation and health outcomes in asthma and COPD.NPJ primary care respiratory medicine · 2018Pooled it
- Device use errors with soft mist inhalers: A global systematic literature review and meta-analysis.Chronic respiratory diseasePooled it
- Advantages and challenges of training of inhalation technique with the Vitalograph AIM device.Scientific reports · 2026Trial
- Impact of pharmacist-led intervention in medication adherence and inhaler usage on asthma and chronic obstructive pulmonary disease control: a quasi-experimental study.BMC health services research · 2024Trial
- Effect of pharmacist-led inhaler technique assessment service on readmissions in hospitalized COPD patients: a randomized, controlled pilot study.BMC pulmonary medicine · 2022Trial
- The effects of repeated inhaler device handling education in COPD patients: a prospective cohort study.Scientific reports · 2020Trial
- A randomized, open-label, single-visit, crossover study simulating triple-drug delivery with Ellipta compared with dual inhaler combinations in patients with COPD.International journal of chronic obstructive pulmonary disease · 2018Trial
- Effects of a COPD self-management support intervention: a randomized controlled trial.International journal of chronic obstructive pulmonary diseaseTrial
- Article
- Article
- Effects of empowerment model-based telenursing interventions on empowerment in individuals with COPD.BMC nursing · 2025Article
- Article
- Latent profile analysis for medication adherence in patients with chronic obstructive pulmonary disease.BMC pulmonary medicine · 2025Article
- Challenges and Opportunities for the Management of COPD: A Narrative Review of Patient and Health Care Professional Perspectives.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- Non-Pharmacological Interventions to Prevent Oropharyngeal Candidiasis in Patients Using Inhaled Corticosteroids: A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- A Brief Report on a Systematic Review of Real-World Effectiveness Studies of ICS/LAMA/LABA for Treatment of Adults with Asthma in the US.Pulmonary therapy · 2025Review
- Investigating Adherence to Asthma Management with an Electronic Monitoring System.Patient preference and adherence · 2025Article
- Effective inhaler technique education is achievable - assessment and comparison of five inhaler devices errors.Frontiers in pharmacology · 2025Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
With the current wealth of new inhalers available and insurance policy driven inhaler switching, the need for insights in optimal education on inhaler use is more evident than ever. We aimed to systematically review educational inhalation technique interventions, to assess their overall effectiveness, and identify main drivers of success. Medline, Embase and CINAHL databases were searched for randomised controlled trials on educational inhalation technique interventions. Inclusion eligibility, quality appraisal (Cochrane's risk of bias tool) and data extraction were performed by two independent reviewers. Regression analyses were performed to identify characteristics contributing to inhaler technique improvement. Thirty-seven of the 39 interventions included (95%) indicated statistically significant improvement of inhaler technique. However, average follow-up time was relatively short (5 months), 28% lacked clinical relevant endpoints and all lacked cost-effectiveness estimates. Poor initial technique, number of inhalation procedure steps, setting (outpatient clinics performing best), and time elapsed since intervention (all, p < 0.05), were shown to have an impact on effectiveness of the intervention, explaining up to 91% of the effectiveness variation. Other factors, such as disease (asthma vs. chronic obstructive pulmonary disease), education group size (individual vs. group training) and inhaler type (dry powder inhalers vs. pressurised metered dose inhalers) did not play a significant role. Notably, there was a trend (p = 0.06) towards interventions in adults being more effective than those in children and the intervention effect seemed to wane over time. In conclusion, educational interventions to improve inhaler technique are effective on the short-term. Periodical intervention reinforcement and longer follow-up studies, including clinical relevant endpoints and cost-effectiveness, are recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.