More than 70% of children or their caregivers were not able accurately identify whether their metered dose inhalers (MDIs) were empty, according to a study in the Archives of Diseases in Childhood.¹

In a multicenter study, researchers from the UK set out to examine if children or their parents or caregivers could correctly identify an empty salbutamol inhaler, which had been prescribed to them for asthma and other respiratory diseases such as cystic fibrosis, bronchiectasis or wheeze between October 2020 and September 2021.

Out of the 157 patients enrolled in the study, nearly 74% (n=125) thought that the empty inhaler was either full or partly full. Just 3 patients used the dose counter, and only 2 kept a record of the number of puffs used. Twelve of 66 preventer inhalers with a dose counter were empty. Instead of returning them to the pharmacy, more than 80% of the patients discarded their inhaler in a dustbin.

Based on their findings, the researchers concluded that “patients cannot reliably identify when their MDI is empty”. Patients often find it difficult to know when their inhaler has become empty or will soon empty unless there is a dose counter. This study highlights the need to educate patients not only about the correct technique of using the inhaler but also how to recognize that the metered dose inhaler is empty. Their safe disposal is also important. A medication review is warranted at each follow-up visit. Keeping a record of the number of puffs used may not be a feasible option for all. Some inhalers do have a built-in counter. But all MDIs should mandatorily have a dose counter, which counts either the number of doses used or left, in a cost-effective manner.

Reference

1. Fullwood I, et al. Do you know when the inhaler is empty? Arch Dis Child. 2022 May 12;archdischild-2022-324027. doi: 10.1136/archdischild-2022-324027.