The curious incident of the inhaler using dog and other remarkable inhaler technique stories from real-life clinical practice. An IRW study

Background: It is generally known that inhaler technique is poor. This is illustrated by many stories form real-life clinical practice among which the story of dog Max. Max9s boss was prescribed with an inhaler, to be used max. 4 times a day. Patient9s symptoms did not improve and it appeared to be that the dog Max was the inhaler medication. 4 times a day. Aim: The Inhaler Research Workgoup (IRW) study aims to improve inhaler instructions in patients with asthma and COPD with a multidisciplinairy approach. Method: In the Netherlands we have interviewed 67 (age 6-90 years) patients and performed 2 focusgroups with 21 health care profesisonals. Moreover, we are performing a literature studie to detect effective theory based instruction methods that can be used to teach inhaler technique. Results: Patients provided us with relevant suggestions to improve inhaler technique. Asthmatics would like to know the reasoning behind the technique. COPD patients have sometimes difficulties with handling the device. We have videorecorded patients9 inhaler technique and permission to show at conferences. Communication between professionals is suboptimal and it is a challenge to obtain enough time for instructions. Literature provided us with promissing suggestions for evidence based teachning methods. Conclusion: We found several achievable options for improvement. At the ERS we would like to share this knowledge about inhaler technique. We wil provide suggestions for improvement at organisational level, at educational level and for contemplation of the correct inhaler technique. Epilogue: After explanation, Max9s boss started to use his inhaler...