Evidence map›Paper›PMID 42799340›Full record

Observational studyCanadian respiratory journal2026

Critical Errors in Inhaler Technique Among Patients With Asthma and COPD: A Cross-Sectional Study in a Real-World Setting.

Italo Henrique Medeiros Damasceno, Ricardo José Fonseca De Oliveira, Sabrina Joany Felizardo Neves, Rand Randall Martins, Rodrigo Dos Santos Diniz

Abstract readObservational Study
In one paragraph

Observational study in Canadian respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Italo Henrique Medeiros DamascenoPostgraduate Program in Pharmaceutical Services and Policies, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil, ufrn.br.ORCID https://orcid.org/0009-0008-2526-9029
Ricardo José Fonseca De OliveiraUniversity Hospital Onofre Lopes, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil, ufrn.br.ORCID https://orcid.org/0000-0001-5229-8177
Sabrina Joany Felizardo NevesInstitute of Pharmaceutical Sciences, Federal University of Alagoas, Maceió, Brazil, ufal.edu.br.ORCID https://orcid.org/0000-0001-9651-0600
Rand Randall MartinsPostgraduate Program in Pharmaceutical Services and Policies, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil, ufrn.br.ORCID https://orcid.org/0000-0001-9668-0482
Rodrigo Dos Santos DinizPostgraduate Program in Pharmaceutical Services and Policies, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil, ufrn.br.ORCID https://orcid.org/0000-0002-2634-0447

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 001
6 · The paper itself

Abstract

backgroundThe correct use of inhalation devices is essential for achieving adequate control of asthma and COPD; however, critical errors in inhalation technique are frequent and substantially reduce treatment effectiveness. This study's objective was to evaluate the prevalence of inadequate inhalation technique among patients with asthma and COPD and to identify the most common critical errors and the factors associated with incorrect use.

methodsThis cross-sectional observational study included 575 patients (aged ≥ 18 years) with asthma and/or COPD, recruited from a university hospital outpatient pulmonology clinic and a public specialized pharmacy (Natal, Brazil). Participants completed sociodemographic questionnaires and demonstrated their inhaler technique, which was assessed using device-specific checklists to identify critical errors. Factors associated with critical errors were analyzed using multivariable logistic regression.

resultsOnly 8.2% of participants correctly performed all steps of the inhalation technique. At least one critical error was observed in 73.4% of the cohort. In multivariable analysis, advanced age (OR: 1.029; 95% CI: 1.016-1.044), use of multiple devices (OR: 2.500; 95% CI: 1.754-3.562), and type of mechanism independent of inspiration (OR: 0.262; 95% CI: 0.160-0.430; protective factor) were significantly associated with critical errors (p < 0.001).

conclusionsInadequate inhalation technique, particularly the occurrence of critical errors, was highly prevalent, especially among older patients and those using multiple devices. Inhalers dependent on inspiratory effort demonstrated greater vulnerability to incorrect use.

Indexed as

AsthmaNebulizers and VaporizersPulmonary Disease, Chronic ObstructiveAdministration, InhalationAdultAgedBrazilCross-Sectional StudiesFemaleHumansMaleMiddle AgedasthmaCOPDcritical errorsinhalation devicesinhaler technique

Identifiers

PMID42799340
PMCPMC13615514

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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.