RESPIRATORY SYSTEM

Relevant guidelines:

• Respiratory Medicine guidelines
• Respiratory Inhalers: a guide to identification, prescribing and technique.
• SIGN 158 British guideline on the management of asthma produced in conjunction with the British Thoracic Society.
• NICE CG101 Chronic obstructive pulmonary disease in over 16s: diagnosis and management
• GOLD Global initiative for chronic obstructive lung disease

Patients should receive regular face-to-face review to ensure correct inhaler technique, self-management (where appropriate) and concordance with agreed treatment. Information for patients is available at http://mylungsmylife.org/. Consider referring patients with COPD to pulmonary rehabilitation.

To achieve optimal compliance with inhaled therapy consider the following:

• base the choice of inhaler device on patient acceptability, suitability and cost.
• patients should only be given a device they can demonstrate they can use; many adults struggle to use metered dose inhalers (MDI) therefore dry powder inhalers (DPI) or other breath activated devices should be considered.
• always take appropriate time to teach and check inhaler technique.
• where possible use the same inhaler device if a patient requires a number of different inhaled medicines.
• reduce the number of inhalers by use of appropriate combination products.