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Appropriate selection and correct use of inhalation devices is an integral component in the management of asthma
Asthma is a chronic respiratory condition with estimated prevalence of childhood asthma in India is 7.9% with higher prevalence among boys and in urban areas. The delivery of medicines by inhalation is an integral component in the treatment and management of patients with Asthma. Appropriate selection and correct use of inhalation devices is an integral component in the management of asthma. It is well known that there are many challenges with the use of inhalers, and no one device suits all patients. Furthermore, problems with inhaler use can be most evident in children and older patients. Dr Vivek Singh, Director, Respiratory & Sleep Medicine, Medanta, Gurugram discusses the aspects for consideration with choosing the right devices for Asthma.
Types of Inhalers and How They Work
Inhalers are small, handheld devices that allow you to breathe medicine in through your mouth, directly to your lungs. Types include metered-dose, dry powder and soft mist inhalers.
Metered dose inhalers
Metered dose inhalers (MDIs or pMDIs), sometimes called “puffers,” hold the medication in a pressurized canister. The canister sits in a handheld container with a mouthpiece.
Dry powder inhalers
Dry powder inhalers (DPIs) store medicine as a powder inside capsules or other containers that you activate when you’re ready to use the inhaler. Instead, a quick, deep breath is used to pull the powder out and into your lungs.
Soft mist inhalers
Soft mist inhalers turn liquid medicine into a fine mist. You breathe the mist in through your mouth to get the medicine to your lungs.
Why One Inhaler Doesn’t Fit All
Asthma treatment isn’t one-size-fits-all. The choice of inhaler matters just as much as the medication it delivers. Factors like age, asthma severity, lung strength, and hand coordination all influence which inhaler is best for a patient. For example, older adults may struggle with the coordination needed to use a metered-dose inhaler (MDI), while young children may not have the lung power to use a dry powder inhaler (DPI) effectively. That’s why personalization is key to managing asthma successfully.
The Role of Doctors and Pulmonologists
Doctors and pulmonologists assess patients through lung function tests and help match the right inhaler to everyone’s needs. They also educate patients on proper technique. Health education and counselling services should be consistently provided to the clients regarding the proper steps of inhalers use.
Technique Matters
Even the right medication won’t work if used incorrectly. An observational study done in India on an incorrect inhaler technique showed that, out of 89 patients using MDI, only 10 (11.2%) patients could demonstrate all the steps of inhaler usage correctly. 88.7% of patients had errors in one or more steps of the inhaler technique.
Patients should feel empowered to ask questions, learn their technique, and check it often. Tools like reminder apps and smart inhalers can track usage and offer helpful nudges.
Managing asthma isn’t just about the drug—it’s about using the right device the right way. Personalization and proper technique can lead to fewer symptoms and a better quality of life. Talk to your doctor today to find the inhaler that is right for you.
