Simple is best: Hong Kong pharmacists criticise over-complex inhalers
Group finds one inhaler that requires 35 procedures on first use and may therefore compromise treatment
Patients are being advised to choose inhalers with a simple design after a pharmacists’ group discovered one that was so complex that it might compromise treatment.
The Society of Hospital Pharmacists analysed features of seven types of commonly used inhalers for patients with asthma and chronic obstructive pulmonary disease – an untreatable lung disease that makes it hard to breathe.
The soft mist inhaler in question, which can be used to relieve the symptoms of both conditions, requires patients to carry out 35 procedures for the first time before they can breathe in the medication.
The steps include inserting the medication cartridge into the inhaler and turning a separable base at least three times to get the drug ready for use.
William Chui Chun-ming, the society’s president, said patients would often forget the proper steps even after pharmacists demonstrated what to do.
“Some patients might not know how to use and give up without telling the doctor,” Chui said.
A metered-dose inhaler, the most common model used by around 60 per cent of patients in need of inhaled medication, requires precise hand-mouth coordination to deliver the drug into the trachea.
“It is difficult to breathe in the aerosol, especially for the elderly who are not so strong,” Chui said.
He said patients might not feel whether the mist, which is tasteless, has entered their mouth.
Another problem is that patients in public hospitals sometimes mistakenly swallow capsules that should be inserted into a dry-powder inhaler, another type of device for sufferers.
Overseas research showed that as many as 70 per cent of patients did not know how to use an inhaler properly, which could lead to delays in treatment.
Dr James Ho Chung-man, a specialist in respiratory medicine at the University of Hong Kong, said he had seen mist coming out of a patient’s mouth after he asked that person to show him how to use the inhaler.
While the choice of inhaler depended on the illness, medical workers advised patients to discuss with their doctors and pharmacists whether simpler inhalers could be used.
