Metered-Dose Inhalers

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Abstract
Objective: The specific aim of this investigation was to evaluate the proficiency of health care providers and patients in the proper use of metered-dose inhalers. Design, Setting, and Participants: Health care providers, which include house staff, nurses, and respiratory care practitioners who provide care to patients with asthma in the primary general medicine clinic or the pulmonary medicine clinic of a university-county hospital in which patients were referred, were surveyed and assigned a performance score regarding the knowledge base of the appropriate use of metered-dose inhalers. Patients who attended the primary care general medicine and pulmonary subspecialty clinic were also assessed as to their proficiency in the use of metered-dose inhalers. Results: A significant percentage of patients had a poor understanding of the technique used with the metered-dose inhaler. House staff and nursing staff were also less proficient in the proper use of the metered-dose inhaler. The respiratory care practitioners were the most knowledgeable of the health care providers. Conclusions: This study confirms that a large percentage of patients use metered-dose inhalers improperly. It also demonstrates a significant lack of understanding by health care providers of the proper use of metered-dose inhalers. Furthermore, this study supports the use of respiratory care practitioners in the outpatient setting, since they were the most proficient among all the health care providers in the proper use of metered-dose inhalers. (Arch Intern Med. 1993;153:81-85)