Asthma accounts for 2-3 % of primary care consultations , 60,000 hospital admissions and 200,000 inpatient bed days each year . 1 COPD affects an estimated 3 % of the population aged 35 and over ( although the diagnosed prevalence is just 2 %). 2 , 3 Beyond lifestyle and non-pharmacological interventions , medication taken via inhaler devices is the mainstay of treatment for these patients . Helping patients choose the right inhaler and ensuring they can use them properly makes a huge difference to their quality of life and outcomes .

Here are ten tips for helping people with long-term respiratory conditions make best use of inhaled medication to control their disease .

Know how to use devices yourself

There are now more than 100 types of inhaler device , with various medications or combinations of medications available . Evidence shows healthcare professionals in general are not confident in checking or teaching correct inhaler technique , 4 but it is crucial to familiarise yourself with the right technique for the type of inhaler prescribed : slow and steady for a metered dose inhaler ( MDI ) or mist inhaler , fast and hard for a dry powder inhaler ( DPI ). These basics need to be supplemented with a knowledge of priming , actuation and care of the device . To support this process and enable professionals to demonstrate competence , the UK

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Inhaler Group has released an Inhaler Standards and Competency Document . 5

Tailor the device to the patient

Various sources of information can help to decide on the right device for a patient . The first consideration is the drug , drug class or combination of medicine required . Not every medication or combination is available in all types of device . A good source of information is RightBreathe ( see Resources ), also available as a mobile app . It features a search-andfilter function and a video on correct inhaler technique for each product . Local formularies will help to guide prescribing in line with locally agreed recommendations . Considerations beyond correct inhalation technique might include manual dexterity , and the shape and size of the device .

Take time to ensure patients understand

Many people with respiratory conditions do not understand the disease or the action of inhaled medication . This means they are less likely to adhere to their medication and affects their ability to self-manage as symptoms fluctuate . Initial and ongoing education about the condition , supported by reminders of the action of each medication and a personalised written plan can address some of the issues .

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