Assessment of inhalation technique and satisfaction with inhalers in asthmatic patients

Introduction: Asthma Guidelines recommend considering patient preferences for inhaler device. Correct technique and ease of use have been associated with good asthma control. Aim: Assess inhalation technique and satisfaction with inhaler devices. Methods: Cross-sectional study including patients aged ≥ 15 years, with confirmed asthma diagnosis and using the same inhaler for at least 3 months. They were assessed on inhalation technique; then they answered the Asthma Control Test (ACT) and the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire translated to Tunisian dialect. FSI-10 is consisting of 10 questions;high satisfaction was considered for a score ≥43. Results: A total of 48 patients were included, with a mean age of 49±16.6 years. The mean time of using inhaler was 4±6.2 years.The most common inhalers were: pressurized Metered-dose-inhaler (pMDI=52%) and Aerolizer (AZ=30%), then Diskus (DK=10%), Turbuhaler (TH=4%) and Nexthaler (NH=4%). A high satisfaction with inhaler was identified in only 29.2% of patients. The mean total score on the FSI-10 for each of the inhalers was: pMDI: 39.8, AZ: 40.4, DK: 42; TH: 41 and NH: 47.5 (p=0.17). FSI-10 score was correlated to ACT score (r=0.388,p: 0.006). Technique errors were found in 60.4% of patients. Among these patients, FSI-10 score lower (39.2 vs 42.6,p=0.004). Errors were most common in illiterate patients (100% vs 48,6%;p=0.002), however there was no significant difference in FSI-10 score regarding education level (p=0,109). Conclusion: Knowledge of the most frequent errors of the inhalation technique and patient satisfaction with inhaler can help in choosing the adequate device, improving adherence to therapy.