Omar Usmani|Federico Lavorini|Jonathan Marshall|W. Dunlop|Louise Heron|Emily Farrington|Richard Dekhuijzen
Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes
Royal Brompton Hospital|Imperial College London|Azienda Ospedaliero-Universitaria Careggi|Mundipharma (United Kingdom)|Mundipharma (United Kingdom)|Adelphi Group (United Kingdom)|Adelphi Group (United Kingdom)|Radboud University Nijmegen|Radboud University Medical Center
inhaled drug delivery cornerstone treatment asthma chronic obstructive pulmonary disease copd however use inhaler devices challenging potentially leading critical errors handling significantly reduce drug delivery lungs effectiveness treatmenta systematic review conducted define critical errors impact health outcomes resource use 2004 2016 using key search terms inhaler errors asthma copd search1 associated healtheconomic patient burden search2search1 identified 62 manuscripts 47 abstracts 5 conference proceedings n 114 total search2 identified 9 studies observed 299 descriptions critical error age education status previous inhaler instruction comorbidities socioeconomic status associated worse handling error frequency significant association found inhaler errors poor disease outcomes exacerbations greater healtheconomic burdenwe shown wide variations critical errors defined evidence shows important association inhaler errors worsened health outcomes given negative impact diminished disease outcomes impose resource use findings highlight importance achieving optimal inhaler technique need consensus defining critical noncritical errors