Inhaler Technique Improvement Programme

Project Aim

The aim of the project was to:

  • Improve health of inhaler users
  • Reduce ineffective use of medicines
  • Describe lessons learned in engaging community pharmacists in other health improvement initiatives

Project Benefits

The project improved the health of inhaler users by allowing health care practitioners to:

  • assess patient’s inhaler technique
  • teach a good technique

The project allowed patients to:

  • assess their own technique
  • reinforce a good technique


The rationale behind the project is simple – most patients with a lung disease who use an inhaler do so with a poor technique. Many care practitioners who teach inhaler technique teach a poor technique. The main aspect of poor technique is too high an inspiration rate. Poor technique leads to most of the inhaled medication being swallowed instead of inhaled and as such is largely wasted. This waste reduces the efficacy of the medication. Low efficacy leads to poorer disease control and higher rates of exacerbation and death.

Project Outcomes

A full evaluation of the project was carried out which found:

  • The Inhaler Technique Improvement Project was a success on a number of levels:

– at the level of the individual patient (improved outcomes and quality of life),

– at a health systems level (improvements in emergency admissions),

– in innovation (use of IT system and inhaler devices),

– in education terms (enhanced skills applied in respiratory and other health related areas); and

– in a more generic sense of the HIECs bringing together and integrating all component areas into a cohesive and effective entity

  • From the start of the project in April 2011, over four thousand Asthma Control Test (Medicine Use Reviews) MURs were conducted and almost 600 2nd (“follow up”) Asthma Control Test MURs were completed; 828 COPD Assessment Test pre- and post MURs were conducted
  • A high number of Community Pharmacies engaged with the project – 206 up to and including August 2012
  • The project delivered substantial improvements in the management of both asthma and COPD
  • Data on emergency admissions suggests a positive association between the introduction of the inhaler technique improvement project and changes in hospital emergency admissions.
  • A number of innovative approaches were successfully applied to the project. These included
    • Innovative approaches to project management and support by the HIEC
    • The use of ESMAQ (Enhanced Services Monitoring and Quality System)
    • The use of inhaler training devices: ‘2-tone inhalers’ and ‘In-Check’ dials 
    • The systematic use of asthma and COPD assessment tests
    • The innovative use of second intervention MURs
    • Innovative approaches to training and development


For a summary of the project, HIEC summary INHALER eversion

 The full report, 120904 CIREM_ITIP_HIEC_Evaluation

Recognition for the Inhaler Technique Improvement Programme :- any town health system




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