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Does the Inhaler Technique Education by a Pharmacist Using Assessment Tools Contribute to Disease Control?
J. Kor. Soc. Health-syst. Pharm. 2021;38:206-223
Published online May 31, 2021;
© 2021 Korean Society of Health-System Pharmacists

Jee Hu Ko*, So Young Lee*, Min Jung Geum, Jae Song Kim, and Eun Sun Son

Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
Correspondence to: 김재송 Tel:02-2228-6929
손은선 Tel:02-2228-6888
*고지후와 이소영은 공동 제1저자로서 본 논문에 동등하게 기여함
Received March 22, 2021; Revised April 19, 2021; Accepted April 23, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background : Inhaler use is the first-line therapy for asthma and chronic obstructive pulmonary disease (COPD), and the proper way to use an inhaler is an important factor for clinical outcomes. Although previous studies have already proved the improvement of the inhaler technique (IT) and disease control through education, few studies have proved the correlation between these two factors. In this study, we aim to unravel the clinical effect of the IT education using an assessment tool, through observation of IT and disease control and analysis of the correlation between the two factors.
Methods : A retrospective, pre-post cohort analysis was performed in patients who were prescribed inhalers for asthma and COPD from June 1 to August 31, 2020 and who received 2 or more education sessions about their inhalers from pharmacists. The IT was measured using assessment tools for each type of inhaler device before the 1st education session, after the 1st education session, and before the 2nd education session. For the evaluation of disease control, self-assessment tools, such as asthma control test (ACT) and COPD assessment test (CAT), were used. We observed the changes in the IT score and ACT or CAT score. We also analyzed the correlation between ACT or CAT score change and IT score.
Results : A total of 26 asthma and 31 COPD patients completed 31 and 36 2nd education sessions, respectively. There was a negative correlation between the CAT score change and IT score (r=-0.439, p=0.007). In all patients, the IT score was significantly increased to 66.9±31.6 directly after the 1st education session (p<0.001), and maintained until 2nd education (p=0.097). The CAT score was decreased 3.03±7.00 (p=0.014), and ACT score was increased to 1.68±4.48 (p=0.046) with significance.
Conclusion : There is a correlation between IT and disease control in COPD, which means solely education about IT can improve the quality of life and pulmonary function of COPD patients. A similar trend was found in asthma, but further research with quality scale is needed to prove the correlation.
Keywords : Chronic obstructive pulmonary disease, Asthma, Inhaler, Inhalation technique, Medication counseling