Several Barriers

Patient-related barriers

• poor inhaler technique
• lack of adherence
• physical/cognitive limitations

Approach:

Demonstrate with placebo devices,Teach-back method, visual aids, device simplification, spacer use for pMDIs

Educate care-givers

Multi-disciplinary approach with pharmacists, nurses

Re-assess, Follow-up

4C approach

• Choose: appropriate device, simplify, spacer or not?
• Check: inhalation technique
• Correct: re-assess and correct errors
• Confirm: clinician should be able to demonstrate accurate technique, support from nurses and pharmacists