Pneumology - Original Articles
21 July 2025
Early Access
https://doi.org/10.4081/monaldi.2025.3498

Evaluation of symptom control in chronic obstructive pulmonary disease after reinforcement of proper inhaler technique

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
COPD, inhaler technique, symptom control, COPD assessment test, patient education, adherence, quality of life
0
Views
0
Downloads

Authors

Tanya Jaiswal
Department of Pharmacology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Sparsh Gupta
Healing_sparsh@yahoo.co.in
Department of Pharmacology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Pooja Anand
https://orcid.org/0000-0002-0475-2213
Department of Pharmacology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India.
Pranav Ish
Department of Pulmonary Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Dhruv Sakkarwal
Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Divya Sahu
Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality worldwide. Proper inhaler technique is a critical component of effective COPD management, yet it is often suboptimal in clinical practice. This study aimed to evaluate the impact of reinforcing proper inhaler techniques on COPD symptom control. This was a pre-post, prospective study conducted in the Department of Pharmacology at a tertiary care hospital in Delhi. A total of 118 COPD patients using inhalers were enrolled. A prospective study of 118 COPD patients using either dry powder inhalers or metered dose inhalers was carried out in the outpatient clinic of our hospital. Participants received structured demonstrations of proper inhaler technique at baseline (day 0), week 4, and week 8, with final evaluations at week 12. Symptom control was assessed using the COPD Assessment Test (CAT) score, and inhaler technique was evaluated using the Inhaler Technique Score (ITS). Adverse effects were monitored and documented. The study demonstrated a significant improvement in both CAT and ITS scores over the 12-week follow-up. The proportion of participants achieving optimal CAT scores (0-10) increased from 4.24% at baseline to 12.7% by week 12. Concurrently, the percentage of participants scoring the maximum ITS of 10 increased from 0% at baseline to 90.7% by week 12. Adverse effects were minimal, with 92.37% of participants reporting no adverse effects. A negative correlation was observed between changes in ITS and CAT scores, highlighting the effectiveness of the intervention in improving COPD symptom control. In conclusion, reinforcing proper inhaler technique through structured educational interventions significantly improves COPD symptom control, as evidenced by enhanced CAT and ITS scores. This study emphasizes the need for routine education and reinforcement of inhaler use in COPD management to achieve optimal clinical outcomes.

Altmetrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Agarwal AK, Raja A, Brown BD. Chronic obstructive pulmonary disease. Treasure Island (FL): StatPearls Publishing; 2025.
Sharma M, Joshi S, Banjade P, et al. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 guidelines reviewed. Open Respir Med J 2024;18:e18743064279064. DOI: https://doi.org/10.2174/0118743064279064231227070344
Agustí A, Celli BR, Criner GJ, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 report: GOLD executive summary. Am J Respir Crit Care Med 2023;207:819-37. DOI: https://doi.org/10.1164/rccm.202301-0106PP
Rogliani P, Ora J, Puxeddu E, et al. Adherence to COPD treatment: myth and reality. Respir Med 2017;129:117-23. DOI: https://doi.org/10.1016/j.rmed.2017.06.007
Sanduzzi A, Balbo P, Candoli P, et al. COPD: adherence to therapy. Multidiscip Respir Med 2014;9:60. DOI: https://doi.org/10.4081/mrm.2014.395
Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis 2008;3:371-84. DOI: https://doi.org/10.2147/COPD.S3036
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD assessment test. Eur Respir J 2009:34:648-54 DOI: https://doi.org/10.1183/09031936.00102509
Pothirat C, Chaiwong W, Phetsuk N, et al. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis 2015;10:1291. DOI: https://doi.org/10.2147/COPD.S85681
Abbas MA, Tariq O, Zafar SB, et al. Improvement in inhaler techniques after training and counseling in patients with chronic obstructive pulmonary disease or asthma. Cureus 2024;16:e62255. DOI: https://doi.org/10.7759/cureus.62255
Melani AS, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011;105:930-8. DOI: https://doi.org/10.1016/j.rmed.2011.01.005
AL-Jahdali H, Ahmed A, AL-Harbi A, et al. Improper inhaler technique is associated with poor as copd control and frequent emergency department visits. J Allergy Clin Immunol 2013;9:8. DOI: https://doi.org/10.1186/1710-1492-9-8
Petrova G, Stoimenova A, Dimitrova M, et al. Assessment of the expectancy, seriousness and severity of adverse drug reactions reported for chronic obstructive pulmonary disease therapy. SAGE Open Med 2017;5:205031211769040. DOI: https://doi.org/10.1177/2050312117690404
Bergs I, Just KS, Scholl C, Dreher M, et al. Inhalation therapies in COPD - adverse drug reactions impact on emergency department presentations. Eur J Clin Pharmacol 2022;79:219-27. DOI: https://doi.org/10.1007/s00228-022-03433-9

Ethics approval

Ethical clearance taken from the Institutional Ethics Committee, VMMC, and Safdarjung Hospital, New Delhi with serial no IEC/VMMC/SJH/THESIS/2023/CC-255dated 27/03/2023.

How to Cite



“Evaluation of Symptom Control in Chronic Obstructive Pulmonary Disease After Reinforcement of Proper Inhaler Technique”. 2025. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2025.3498.
Copyright (c) 2025 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.