Most Patients Incorrectly Use Autoinjectors, Inhalers

The majority of patients who require inhalers for asthma or epinephrine autoinjectors for allergic disease do not use the devices properly, according to a study that will appear in the January 2015 edition of the Annals of Allergy, Asthma and Immunology.

"Improving how patients use these devices leads to better clinical outcomes," said first study author Rana Bonds, MD, an assistant professor at the University of Texas Medical Branch (UTMB) at Galveston. "We conducted an investigation to identify factors associated with incorrect use of inhalers and epinephrine autoinjectors at UTMB so that health care providers are aware of the problem and can plan better ways to increase proper usage."

In the study, only 7% of the 44 patients who used metered-dose inhalers showed perfect technique, and 63% missed 3 or more steps. The most common misstep was failing to exhale as much as possible prior to using the inhaler.

Similarly, only 16% of the 102 patients who used epinephrine autoinjectors, such as EpiPen, demonstrated that they knew how to use them properly, and more than half missed 3 or more steps. Common errors associated with autoinjector use included failing to hold the injector in place for at least 10 seconds and not depressing the device forcefully enough.

"Despite the redesign of the autoinjector for easier use, most patients continued to make at least one mistake with the device,” Dr. Bonds stated. “Most patients made multiple mistakes and would not have benefitted from self-administration of the potentially life-saving treatment if the need arose."

As a result of those significant missteps, inhalers and epinephrine autoinjectiors are delivering medications less effectively, which the researchers said could result in disastrous outcomes for patients. Thus, the study authors recommended that health care professionals provide repeated verbal and visual education using demonstration to potentially save lives.