Clinical profile, inhaler technique, and predictors of inhaler adherence among asthma and COPD patients who attended the outpatient emergency department for acute exacerbation

Understanding the patients’ clinical profile, barriers to optimal inhaler use, and adherence are crucial in achieving the treatment goal for asthma and chronic obstructive pulmonary disease (COPD). This study aimed to assess the inhaler technique and identify the predictors of inhaler adherence amon...

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Bibliographic Details
Published in:Internal and emergency medicine Vol. 20; no. 6; pp. 1909 - 1916
Main Authors: Koh, Hock Peng, Teoh, Paula Suen Suen, Roslan, Nurul Liana
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01.09.2025
Springer Nature B.V
Subjects:
Administration, Inhalation
Adult
Age
Aged
Asthma
Asthma - drug therapy
Asthma - psychology
Chronic obstructive pulmonary disease
Counseling
Cross-Sectional Studies
Data analysis
Data collection
EM - Original
Emergency medical care
Emergency Service, Hospital - organization & administration
Emergency Service, Hospital - statistics & numerical data
Female
Hospitals
Humans
Inhalers
Internal Medicine
Lung diseases
Male
Medication Adherence - psychology
Medicine
Medicine & Public Health
Middle Aged
Mortality
Nebulizers and Vaporizers - standards
Nebulizers and Vaporizers - statistics & numerical data
Patient compliance
Patients
Prospective Studies
Pulmonary Disease, Chronic Obstructive - drug therapy
Pulmonary Disease, Chronic Obstructive - psychology
Regression analysis
Respiratory diseases
Malaysia
Inhaler adherence
Emergency Department
Inhaler technique
Asthma
COPD
ISSN:1828-0447, 1970-9366, 1970-9366
Online Access:Get full text
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Summary:Understanding the patients’ clinical profile, barriers to optimal inhaler use, and adherence are crucial in achieving the treatment goal for asthma and chronic obstructive pulmonary disease (COPD). This study aimed to assess the inhaler technique and identify the predictors of inhaler adherence among asthma and COPD patients who presented to the Emergency Department (ED). This prospective cross-sectional study recruited patients who presented to the outpatient ED of a tertiary hospital for mild-to-moderate exacerbation from March 2022 to February 2023. Convenience sampling was used in this study. The inhaler techniques and adherence of all subjects were evaluated. Regression analysis was used to identify predictors of inhaler adherence. We recruited 120 subjects with a mean age of 47.8 ± 16.0 and were predominantly asthma patients ( n  = 85, 70.8%). Most were on regular follow-up ( n  = 72, 60.0%) and adhered to their inhaler(s) ( n  = 86, 71.7%). Less than half of the subjects use their inhaler(s) correctly ( n  = 45, 37.5%). Three predictors of inhaler adherence were identified: regular follow-up (aOR 2.072, p  = 0.041), correct inhaler technique (aOR 3.071, p  = 0.039), and ability to explain inhalers’ mode of action (aOR 10.906, p  = 0.031). The high rate of wrong inhaler techniques among asthma and COPD patients is worrisome. Identified predictors of inhaler adherence should be targeted when managing this group of patients. In addition to the exacerbation treatment in the ED, referrals to public primary health clinics for regular follow-ups, evaluation of inhaler techniques, and counseling to enhance patient knowledge are crucial.
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ISSN:1828-0447
1970-9366
1970-9366
DOI:10.1007/s11739-024-03810-5