Is It Possible to Achieve Better Asthma Control by Using the Same Inhaler Device?

© Copyright The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease http://e-aair.org Achieving asthma control is central to optimizing patient quality of life and clinical outcomes. This definition of asthma control has two components: achieving current clinical asthma control and reducing future risk. The level of clinical asthma control is defined by the Global Initiative for Asthma (GINA) using a composite score comprising five measures. Reducing asthma exacerbations is a key factor for preventing future risk. The regular use of inhaled corticosteroids (ICS) is essential for controlling asthma symptoms and reducing asthma exacerbations. A previous study found that a history of exacerbations, poor asthma control, poor inhaler technique, a history of lower respiratory tract infections, poor adherence to medication, and the presence of co-morbid conditions all predicted the future risk of asthma exacerbation. Most control medications, including ICS, are delivered via inhalation. The correct use of inhaler devices is critical for optimizing drug delivery and obtaining clinical benefits. However, inhaler use still represents an important challenge for most asthmatic patients. The correct inhalation maneuver differs markedly for different inhaler types. The problems and prevalence of incorrect inhaler use have been the subject of several recent reviews. Improper technique remains common for both metered dose (MDIs) and dry power (DPIs) inhalers, and was associated with poor clinical control and increased unscheduled health-care demands in asthma clinics. Inhaler mishandling continues to be common among experienced outpatients referred to asthma clinics and is associated with increased unscheduled health care resource use. Nevertheless, inhaler technique status has not been included in most analyses examining the predictors of asthma exacerbation. Poor adherence to asthma medication is a dilemma, as it decreases the chance of achieving and maintaining proper asthma control. Education of both patients and health care professionals regarding proper inhaler technique will improve asthma control. The study by Price et al. in this issue is the first to compare Is It Possible to Achieve Better Asthma Control by Using the Same Inhaler Device?