Inhalers in asthma management: is demonstration the key to compliance?

Successful asthma management is 10% medication and 90% education. An ample range of drugs is available to adequately control most asthma, yet a majority of patients with moderate to severe disease fail to adhere to prescribed therapy. Studies examining the degree of compliance with prescribed inhaled therapy range from 24% to 69%.1 This failure is in large part due to the failure of the health care team to effectively communicate the purpose and techniques of prescribed therapy. Compliance with aerosol therapy is complicated by issues of comprehension, competence, and contrivance. The “convenient” answer to patient comprehension is providing the package insert or a printed set of instructions for use and maintenance of an aerosol inhaler. In the United States, which seeks to “leave no child behind,” previous studies have shown that up to 40% of adults (many with high school diplomas), are unable to comprehend simple written instructions.2