Sustained bronchodilation using inhaled medications in moderate to severe
chronic obstructive pulmonary disease (
COPD) grades 2 and 3 (Global Initiative for
Chronic Obstructive Lung Disease guidelines) has been shown to have clinical benefits on long-term symptom control and quality of life, with possible additional benefits on
disease progression and longevity. Aggressive diagnosis and treatment of symptomatic
COPD is an integral and pivotal part of
COPD management, which usually begins with primary care physicians. The current standard of care involves the use of one or more inhaled
bronchodilators, and depending on
COPD severity and phenotype, inhaled
corticosteroids. There is a wide range of
inhaler devices available for delivery of inhaled medications, but suboptimal
inhaler use is a common problem that can limit the clinical effectiveness of inhaled
therapies in the real-world setting. Patients' comorbidities, other physical or mental limitations, and the level of
inhaler technique instruction may limit proper
inhaler use. This paper presents information that can overcome barriers to proper
inhaler use, including issues in device selection, steps in correct technique for various
inhaler devices, and suggestions for assessing and monitoring
inhaler techniques. Ensuring proper
inhaler technique can maximize
drug effectiveness and aid clinical management at all grades of
COPD.