To Örebro University

Overall aim: The overall aim was to investigate and optimize inhaler use and patient education in COPD in primary health care.

Methods: Study I was an observational study assessing patients’ inhaler use. Study II was a non-randomized controlled clinical trial evaluating the effect of an additional inhaler education session. Study III was a register-based study identifying factors associated with patient education. Study IV was a qualitative focus group study exploring asthma/COPD nurses’ experiences of inhaler education.

Results: In Study I, 45% of the 183 patients made at least one inhaler error; 50% made errors related to device handling, 31% made errors relating to inhalation technique, and 19% made both types of error. In Study II, the education group showed a significant improvement in device-handling errors, after one revisit. Study III revealed that only 44% of patients with COPD had received patient education, primarily those with more severe disease. In Study IV, asthma/COPD nurses described inhalation treatment as challenging, and reported deficiencies particularly in continuing education, limited managerial support, and insufficient time for patient care.

Conclusions: The findings demonstrate a high prevalence of incorrect inhaler use among patients with COPD. Categorizing errors into device-handling and inhalation-technique errors may simplify assessment and facilitate more individualized, patient-centered education. Health care organizations should prioritize COPD and support asthma/COPD nurses through education, collaboration, and adequate time for patient care. Patient education, including inhaler training, should be initiated earlier and offered to more patients.