Abstract
Long term treatment of patients with chronic obstructive pulmonary disease is based primarily on inhaled bronchodilators. However, this therapy is associated with high degree of non-adherence.
Up to 85% of patients do not inhale their medicaments effectively. Among the main issues is insufficient education and poor monitoring of patient's inhalation technique.
This article summarizes current inhaled medication and their availability in different types of inhaling systems. Suggests an algorithm that helps choose medicaments, recommends use of simple method called The Five Steps Assessment which tells patients how to use their inhale medicaments in five simple steps.
The article also emphasizes the need of repetitive demonstration of inhaling maneuvers, especially deep exhalation prior to administration of medication and proper inhalation which is different for dry-powder inhalers where quick deep inhale is required and for aerosol inhalers where long and slow inhale is preferable.