Which Inhaler Device Are You? (Or, the One on Device Preference)
Once upon a time in 2016, I made a Buzzfeed-style quiz called Which Inhaler Device Matches Your Style. It’s ridiculous and non-scientific and has nothing to do with you asthma treatment.
The reason I bring this up again, is when having a conversation with my friend Russ about what to write, this happened:
Russ: Do like a quiz. What type of inhaler are you? Just buzzfeed style.
Me: OMG I totally made that before, I wonder if I can find it.[2 minutes later] “Which inhaler device matches your style.”
Russ: *sends result* Wtf that was the worst. Like, your food options sucked.
Me: You’re welcome. Those quizzes are supposed to be terrible.
Russ: Love that you put mac and cheese.
Now that you know which kind of inhaler you are (and that I make really lame quizzes), did you know that how much you actually like one inhaler over another doesn’t actually impact how good you are at using it?
Preferred inhaler device ≠ your most effective device
It turns out, according to a 2017 study called Inhaler Technique in Asthma: How Does it Relate to Patients’ Preferences and Attitudes Toward Their Inhalers, that even when patients are using their preferred type of inhaler device, there’s only a 12% chance they are using it correctly.1 Even if patients are confident with their technique using their preferred inhaler device, it’s most likely they are not using it correctly.1 Yep, seems like as with that quiz I made, your success with the inhaler you’re using has very little to do with how good you actually are at using it properly!
This goes for all types of inhalers, including metered dose inhalers (MDIs/“puffers”) and dry powder inhalers (DPIs).1,2 While DPIs are often touted by users to be “easier” as they do not have to time the actuation of the inhaler with their inhalation, there is still a sequence of steps that must be performed. Commonly missed steps when using a DPI include: failure to exhale fully before inhaling from the device, failing to breath-hold after inhalation to allow medication to settle, and being unable to “execute a forceful and deep inhalation”2; as well, incorrect rotation sequence when “loading” the device and incorrect positioning of the inhaler are also common errors when using a DPI… so there is more to it than it may look like!2 Similarly, with MDIs which have a greater number of steps, patients often fail to shake the device, breath-hold, or do not actuate in time with their inhalation.3 (The article also says a critical error experienced is forgetting to remove the cap. Come on, people, I get you on the rest of them but forgetting to remove the cap?!)3
Inhaler technique training and regular checks from doctors are imperative
Just because patients used their “favorite” or “preferred” inhaler device doesn’t mean they did it right.1 So, what you’re successful with may be just as random as that non-scientific quiz on “Which Inhaler Device Matches Your Style”—or, likely more accurately, it comes down to how hard you try to get all the steps down correctly, and to having a professional observe you to see how you’re doing! Although, that depends they also know what they are doing, which isn’t always the case either!
So, just because your doctor prescribed it… or because you like the inhaler… or because you scored that inhaler type on a quiz, doesn’t mean it’s the best choice for you—especially not that last one! It just goes to show that a refresher course in inhaler technique is never a bad idea!
(Oh, and if you did the quiz... did your result match your actual favorite? I’m curious.)
Have you ever gotten "moon face" as a side effect of prednisone?