Analysis of the Accuracy of Inhaler use Technique inPatients with Chronic Respiratory Disease : A CaseStudy

Abstract

Introduction: Correct inhaler technique is critical for achieving optimal

therapeutic outcomes in individuals with chronic respiratory diseases, including

asthma and Chronic Obstructive Pulmonary Disease (COPD). Although Metered-

Dose Inhalers (MDIs) are widely used, incorrect technique persists and leads to

suboptimal pulmonary drug deposition, ongoing symptoms, frequent

exacerbations, and increased healthcare utilization.

Methods: Descriptive interventional case study included five adult outpatients

(aged 18–60 years) diagnosed with asthma or COPD in July 2026. We evaluated

inhaler technique using a standardized nine-step observation checklist derived

from the Global Initiative for Asthma (GINA) and Global Initiative for Chronic

Obstructive Lung Disease (GOLD) guidelines. Participants received individualized

education comprising verbal review, visual demonstration, supervised return

demonstration, and immediate corrective feedback. We reassessed inhaler

technique after the intervention.

Result: Before the intervention, all participants showed moderate inhaler

technique, with a mean score of 6 out of 9 (66.7%). The most frequent critical

errors were observed in the final exhalation step (0% accuracy), shaking the

inhaler for medication homogenization (20%), and synchronizing inhalation with

canister actuation (20%). After the educational intervention, the mean score

increased to 8.8 out of 9, reflecting a 29.3% improvement. Four participants (80%)

achieved perfect performance (9 out of 9), and one participant (20%)

demonstrated good performance (8 out of 9). Accuracy in medication

homogenization and final exhalation improved to 100% following training.

Conclusion: Focused education utilizing the teach-back method effectively

improved inhaler technique and corrected critical psychomotor errors

within a short timeframe. Routine assessment and reinforcement of inhaler

technique should be integrated into respiratory nursing practice to optimize

treatment outcomes and support long-term disease management.