The problem with critical and non-critical inhaler errors
Department of Experimental and Clinical Medicine University of Florence, Largo Brambilla 3, 50134 Florence, Italy
Incorrect use of inhalers is common in real life despite advances in inhaler technology. Inhaler misuse, a consequence of device-related and/or patient-related factors, is associated with worsened health outcomes poorer disease control and increased use of health-care resources. The errors in the use of inhalers can be identified as ‘critical’ (sometimes defined as ‘essential’ or ‘crucial’) errors, which are likely to significantly impair the delivery of adequate medication to the lungs, and ‘non-critical’ errors, which are likely to result in a reduced amount of drug reaching the lungs compared with that attained using the correct technique. However, there is a wide variation in how critical errors are defined. Given the negative impact diminished disease outcomes impose on resource use, correct inhaler technique (mastery) is fundamental for effective therapy, and that inhaler device type and mastery play important roles in improving adherence, clinical outcomes, quality of life, and use of healthcare resources. There is a need for a consensus on defining critical and non-critical errors.