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So many inhalers. Inhaler device awareness audit to better understand

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Inhaler device awareness & understanding audit. Where are we ‘at’ in community pharmacy?

Burton J, Barnet B, Duncan, B  

Background & method
In recent months and years there has been a proliferation of different inhaler devices flooding onto the market, for both asthma and COPD indications.

We wanted to assess the current level of awareness & understanding that pharmacists, pharmacy technicians and dispensing assistants working in our pharmacy group (15 pharmacies) had relating to the now wide range of inhaler & other respiratory devices.

We used a Survey Monkey internet questionnaire to gather information about current levels of awareness and understanding and also ideas for how we support pharmacists and support staff in this area of practice going forward.

Results highlights
31 respondents from May 21 – June 1, 2015

Q1: Are you aware of this inhaler device?
100% said yes for:

Accuhaler, MDI, Easi-Breathe, EasyHaler, peak flow meter

<50% said yes for:

Forspiro/Gyrohaler, NEXThaler, Spiromax, Breezehaler, IN-CHECK Dial

Q2: How comfortable would you be counselling a patient on the proper use of a device?
50% were at least comfortable counselling on:

MDI, Accuhaler, peak flow meter, EasyHaler, Easi-Breathe, Autohaler, HandiHaler, Turbohaler

>30% could not counsel, but were aware of these devices:

Clickhaler, Diskhaler, Respimat, Breezhaler, NEXThaler

Q3: We would like to provide you with more instruction on the devices you dispense. Which of the following would you find beneficial? (Select all that apply):

Most popular choice: Handling a device or placebo version

2nd: Watching a video on the proper use of the device

3rd: Having an easy-to-follow reference guide on the proper use of a device

4th: Having someone teach you the proper use of a device.

5th: Having a training day on inhaler devices

6th: Having a drug rep come and speak about a device




What did we learn?

  • There is a wide variation in levels of awareness and understanding of use across different inhaler devices among pharmacists and other members of the dispensing team. Awareness and understanding around newer device types is particularly poor.
  • Pharmacists and support staff rated having access to placebo & training devices, a reference guide, and watching instructional videos as methods of learning they would find most beneficial.


  • We developed an easy to use set of laminated advice cards for each inhaler device (peak flow meters & In-Check Dial device were included) with internet video references too, and each pharmacy now has one to refer to for staff training andpatient consultation use.
  • We contacted all inhaler manufacturers to obtain supplies of available placebo and training devices, and produced a box ‘kit’ for each pharmacy which accompanies the file of device advice cards. We are also planning a training session at our company conference.
Our visiting US students with the completed inhaler training resources.

Jonathan Burton is vice-chairman of the Royal Pharmaceutical Society Scottish Board, and director of of the Right Medicine Pharmacy group. Bridget Barnett and Barret Duncan are students at the Medical University of South Carolina.

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