ArticleDrugs & aging2020
Assessment of Poor Inhaler Technique in Older Patients with Asthma or COPD: A Predictive Tool for Clinical Risk and Inhaler Performance.
Article in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- Cognitive Impairment as a Putative Mechanism of Self-Management Failure in Chronic Obstructive Pulmonary Disease: A Conceptual Narrative Review.Journal of clinical medicine · 2026Review
- Real-World Adherence to Asthma and COPD Medications in Belgium: A Nationwide Analysis of Determinants Using Dispensing Data and Mixed-Effects Modeling.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Expectations Versus Reality in Inhalation Technique-A Case-Control Study of Inhalation Technique in Patients with Asthma or COPD.Journal of clinical medicine · 2025Article
- Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study.Frontiers in pharmacology · 2024Article
- Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.International journal of chronic obstructive pulmonary disease · 2024Review
- Cognitive impairment according to Montreal Cognitive Assessment independently predicts the ability of chronic obstructive pulmonary disease patients to maintain proper inhaler technique.BMC pulmonary medicine · 2023Article
- Metabolic Phenotypes in Asthmatic Adults: Relationship with Inflammatory and Clinical Phenotypes and Prognostic Implications.Metabolites · 2021Review
- Distribution of COPD Comorbidities and Creation of Acute Exacerbation Risk Score: Results from SCICP.Journal of inflammation research · 2021Article
- Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD.Journal of clinical medicine · 2020Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesOlder patients with asthma or chronic obstructive pulmonary disease (COPD) are particularly susceptible to inhaler technique errors and poor clinical outcomes. Several factors may influence their risk, but most studies are inconsistent and contradictory. We developed a tool for the major predictors of individual risk in these patients. DESIGN, SETTING AND
participantsIn this multicentre, cross-sectional study, several demographic, socioeconomic and clinical characteristics were collected as potential predictors. Clinical features and inhaler technique performance were the main outcomes. Linear and logistic regression models were set up to identify significant variables. Subgroup analysis was performed according to age, cognitive performance and different types of inhalers.
resultsWe included 130 participants, mean age of 74.4 (± 6.4) years. Mean years of device use were 5.8 (± 7.3). Inhaler errors affected 71.6% (95% CI 64-78.5) and critical mistakes 31.1% (95% CI 24-38.8). There were respiratory comorbidities in 82.3% of participants, and 56.2% had moderate to severe disease. A predictive score of misuse probability was developed for clinical practice, including points attributable to cognitive score, adherence and having received previous education on a placebo device. Other significant variables of individual risk were having respiratory allergies or comorbidities, smoking status, depression and educational level. Worse performance was detected in cognitively impaired patients older than 75 years who were using dry powder inhalers (DPI). Lung function was associated with smoking load, incorrect dose activation and absent end pause after inhalation.
conclusionsIndividual risk assessment in older individuals should focus on inhaler technique performance (mainly on dose activation and end pause) and adherence, smoking, respiratory comorbidities and cognitive impairment. Placebo device training provided by doctors seems to best suit these patients.
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