The aim of this study was to evaluate inhaler technique and symptom control in patients with poorly controlled asthma at baseline and at follow-up in a dedicated asthma clinic in a tertiary hospital. We also investigated the impact of asthma on these patients' quality of life.

Methods: Patients referred to a newly established asthma clinic in Cork University Hospital were prospectively recruited over a 6 month period. Their inhaler technique was assessed by a pulmonary nurse specialist using a validated scoring system. They received instruction on inhaler usage when scores were suboptimal. Patients completed a validated asthma control questionnaire (ACQ) and asthma quality of life questionnaire (AQLQ). At follow-up 3-4 months later, inhaler technique was reassessed and the ACQ questionnaire repeated.

Results: 46 patients were recruited (female=74%), and 40/46 were followed up. Mean[SD] FEV1 % predicted at baseline = 76.5%[21.5]. 63% of patients were classified as incorrectly using their inhaler at their initial assessment.This decreased to 20% at follow up, indicating an overall significant improvement in inhaler usage post-training (p=0.003). ACQ scores improved significantly from median[interquartile range] 2.70[1.66] to 2.00[1.90], (p=0.002). Baseline measurement indicated that patients' quality of life was moderately affected by asthma, with a median AQLQ score of 4.75 [1.97]

Conclusion: This study demonstrates the importance of educating and formally assessing inhaler technique in patients with asthma as part of their ongoing clinical review.