Evaluation tools used for assessing inhalation technique in patients with chronic obstructive lung disease –⁠ a literature review

Overview

Introduction and aim: Chronic obstructive lung diseases, including bronchial asthma and chronic obstructive pulmonary disease, among others, are characterized by inadequate adherence to inhalation technique. Evaluation of inhalation technique and subsequent repeated patient's education should be a routine part of therapy management. The aim of this article was to provide an overview of tools used to assess inhalation technique in patients with chronic obstructive lung disease based on a literature search and to analyse in more detail individual questionnaires/checklists specific for a group of inhalers or for a particular type of inhaler.

Methods: Bibliographic database PubMed was used for the literature review. Original papers in Czech, English, German and French published in the period 2014-2023 focusing on assessing inhalation technique in patients with chronic obstructive lung disease were included.

Results: The inclusion criteria were met by 66 studies, of which 49 studies assessed inhalation technique using individual questionnaires/checklists, 10 studies using electronic monitoring devices, 7 studies using the TAI-12 (Test of the Adherence to Inhalers) and 1 study using Vitalograph AIM^TM (Aerosol Inhalation Monitor). In some works, a combination of the above methods was used.

Conclusion: The use of individual questionnaires/checklists, whose reproducibility is limited due to their heterogeneity and inconsistent terminology, dominated the evaluation of inhalation technique. There is a need to introduce a simple validated tool applicable to all types of inhalation systems to unify the assessment of inhalation technique in research and clinical practice.

Keywords:

chronic obstructive pulmonary disease – bronchial asthma – inhalation technique – adherence to inhalation technique – evaluation tools for assessing inhalation technique