Inhaler Technique

If you are living with Chronic Obstructive Pulmonary Disease (COPD) or asthma, it is likely your doctor has prescribed you medicines to help control your symptoms and prevent exacerbations (flare-ups). These medicines act on the airways and the lungs, and so most are taken through an inhaler device.

Different inhaler types

Using an inhaler device is a skill and research shows up to 90% of Australians do not use their inhaler device correctly[1]. By having the right inhaler device technique, you can be sure the medicine is getting to where it needs to be in your lungs and doing what it needs to do to reduce your symptoms.

There are many different types of inhalers now available for COPD and asthma which can be classified as: 

  •  Pressurised metered-dose inhalers (pMDIs) 
  • Breath-actuated metered dose inhalers (bMDIs) 
  • Dry powder inhalers (DPIs, single or multidose), and 
  • Soft mist inhalers. 

Inhalers can contain either a single medicine or a combination of medicines. The choice of inhaler device depends on several factors. The type of inhaler or other device you use will depend on the medicine you are taking and your ability to use the device properly, as well as your own personal preference – tensure that you get the most benefit from your inhaled medicines. 

When to check your inhaler technique

It may be time to check you are using your inhaler correctly if:

  • Taking your inhaled medicine doesn’t seem to improve your breathing
  • A mist of medicine particles comes out of the top of the inhaler when you use it
  • A mist of medicine particles comes out of your mouth when you breathe out after using your inhaler
  • Taking your inhaler medicine is felt mostly on your tongue.
  • You have been prescribed a new inhaler device
  • You haven’t had your delivery device technique checked in the last 12 months, face to face by a health professional.

The steps for using an inhaler correctly differ between brands.  Each time you start a new inhaler device, or your medicine is changed, or a new medicine is added, ask your health professional to show you how to use your inhaler correctly.

Who can check my inhaler technique?

If you are not sure that you are using your inhaled medicines properly, talk to your doctor, pharmacist, or nurse. They can show you how to use your inhalers and other devices, check your technique, or recommend a different type of device for you. It is important to make sure they review your technique at least every year. If you are using more than two inhalers, talk to your doctor about the possibility of reducing the number you need to use. This can often be done without changing the type of medicine inside the inhaler device.

Inhaler device techniques
You can also review your technique at home by watching the inhaler technique video series developed by Lung Foundation Australia. Watch these short videos to learn how to use your inhaler properly and better manage your respiratory symptoms. This will reassure you that you have the correct technique and you are receiving the full prescribed dose of the medicine.

Spacers

A spacer is a holding chamber shaped like a football or tube. It makes it easier to take asthma or COPD medicine from the type of puffer called an MDI (metered dose inhaler).  Spacers help the medicine get straight to where it’s needed in your lungs, with less medicine ending up in your mouth and throat where it can lead to irritation or mild infections. A spacer can also make it easier to coordinate breathing in and pressing your puffer.  There are many different brands and sizes of spacers available. Ask your health professional which spacer might be best for you. Look for one that you can put together easily and that will be convenient for everyday use. 

Why should I use a spacer? 

Using a spacer with your puffer to help improve delivery of the medication into your airways is critical to ensure you get the most benefit from your medication. A puffer and spacer is also less challenging to use than a puffer alone because you don’t have to co-ordinate pressing down on the puffer and breathing in. Spacers are especially useful if you have trouble taking in one big breath and holding your breath. If you use a spacer with your puffer, you can use the four breathe technique, breathing in and out gently on the spacer which you may find easier.

How do I clean my spacer? 

A spacer should be cleaned every 2-4 weeks and following a cold/flu. To clean your spacer: 

  • Pull it apart where possible 
  • Wash it in warm soapy water and allow it to drip-dry; do not rinse it or dry it with a cloth, as this can result in static build up inside of the spacer 
  • Put the spacer back together again once it is completely dry. 

New spacers (e.g. Able Spacer Universal, Volumatic) need to be washed before you use them for the first time. Spacers made from antistatic polymers (e.g. Able A2A, AeroChamber Plus, Breathe Eazy, La Petite E-Chamber, La Grande E-Chamber, OptiChamber Diamond) do not need to be washed before first use, nor do disposable cardboard spacers. 

1 National Asthma Council Australia. Inhaler technique for people with asthma or COPD. 2018