Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care.

This is a baseline observational study, not a test of an intervention or a device comparison. Nurses assessed their own patients, so familiarity or reluctance to record errors may have biased the findings. The checklist was adapted and not fully validated; nurses wrote 64 comments about errors outside the checklist, so true error counts may be higher. Patients with cognitive impairment were excluded, which may understate errors in older or cognitively impaired COPD patients. Nineteen of 183 patients did not answer the baseline questionnaire, so sociodemographic comparisons are based on 164 patients. Participants came from primary care in central Sweden and had a mean age of 71 years, so results may not apply to secondary care or other settings. No device-by-device comparison was possible because some devices had only a limited number of users.

Several authors declared honoraria, lecture fees, advisory board payments, or an unrestricted research grant from pharmaceutical companies that make inhalers, including AstraZeneca, Boehringer Ingelheim, GSK, Novartis, Teva, Chiesi, and Meda.

Do not conclude that one inhaler device is safer or easier to use than another. The study did not compare devices, and some devices had only a limited number of users.