1 million Brits at risk after missing vital inhaler check

Asthma UK says people not taking their life-saving medication properly could put their lives at risk

Wednesday 27 March 2019

More than a million people with asthma in the UK could be at risk of a potentially life-threatening asthma attack because they did not get their inhaler technique checked by their GP or asthma nurse, according to new estimates by Asthma UK.*

Nearly 1 in 5 (19%) people aren’t getting their inhaler technique checked, according to Asthma UK’s report, which included a survey of more than 10,000 people with asthma. This is an essential part of basic asthma care that everyone with asthma should be getting.**

It is vital that adults and children with asthma get help with their inhaler technique as research shows that almost half of people with asthma are not using their inhaler properly***, often without realising. This means the full dose of medicine can’t get into their lungs where it is needed to protect them from a life-threatening asthma attack. The medicine instead stays in their mouth or the back of their throat, which can also make people more likely to experience side effects such as oral thrush and a sore throat.

According to national guidelines**, everyone with asthma should get their inhaler technique checked as part of their yearly asthma review with their GP or asthma nurse. But with dozens of types of inhalers that need to be taken in different ways, it can be difficult for doctors and nurses to know how they all work.

A study showed that 9 in 10 healthcare professionals did not know how to demonstrate the use of an inhaler.****

Asthma UK is calling on doctors, asthma nurses and pharmacists to help patients avoid asthma attacks by supporting them with their inhaler technique. The charity has today launched a suite of videos on its website which demonstrate how to use more than 21 different inhalers, spacers or nasal sprays including pMDI, Turbohaler and HandiHaler.

The videos, which are all around three minutes long and free to access, have been endorsed by the UK Inhaler Group, a coalition of not-for-profit organisations and professional societies with a common interest in promoting the correct use of inhalers to help patients with respiratory conditions.

The charity is also urging patients and parents of children with asthma to attend their asthma reviews and watch the videos with their GP or asthma nurse so they can be mindful of how to use their inhaler properly. The videos can also be accessed by people with asthma on their mobile phones, helping them to further improve their technique whether they’re at home or on the go.

A few small tweaks to their technique could be all that is needed to help people to get the right amount of medicine to prevent an asthma attack. Patients could also consider getting help on their inhaler technique from their local pharmacist.

Asthma UK’s nurses, who provide support to people via a telephone helpline, had more than 3,000 calls last year from people needing help with using their inhaler.*****

There are many common mistakes people with asthma can make when taking their inhaler including breathing too forcefully or not forcefully enough, not breathing in deeply enough, or not preparing their inhaler properly, such as shaking it before use.

If people are struggling to get their inhaler technique right, it can also help if they use a spacer. This is a hollow chamber that attaches to the inhaler and makes it easier for the medicine to get into the lungs, which will help to reduce the likelihood of side effects. Asthma UK have videos dedicated to demonstrating how to use different types of spacers, including spacers for children with a face mask.

Paul Wilson, 44, from Beith near Glasgow, ended up in hospital 48 times because of his asthma and had to be resuscitated on 25 occasions. He missed out on vital inhaler technique checks with his GP because he missed his yearly asthma reviews. He says:

“I’ve been rushed to hospital countless times with my asthma, and been put on drips, nebulisers, and even ended up in intensive care. But I’d never really given too much thought on how to manage my asthma or use my inhaler properly. Looking back, I was just taking a puff and hoping for the best.

“My symptoms were getting so severe that it got to the point where I was having an asthma attack every week. I would wake up in the middle of the night gasping for breath and it felt like someone was sitting on my chest.

“I realised I needed help and booked an appointment with my asthma nurse for a medication review. They said the way I was using my inhaler meant that only 10-20% of the medicine was getting into my lungs. They showed me the correct inhaler technique and gave me a spacer to use, and the difference it has made to my asthma is incredible - I even ran the London Marathon for Asthma UK last year. I never thought that something so simple could completely turn my life around.” 

Dr Andy Whittamore, Clinical Lead at Asthma UK and a practising GP, says:

“Inhalers are the bread-and-butter treatment for most people with asthma, so it’s really worrying that many people are not taking them properly, or getting their technique checked by their GP or asthma nurse.

“With so many different types of inhaler which are all used in different ways, it can be difficult for patients and healthcare professionals to know the correct way to use them. It’s also easy for patients to get into bad habits or simply forget the best technique following their appointment, especially if they have a new type of inhaler.

“But even a small tweak to how someone uses their inhaler can make a huge difference and could prevent them having a life-threatening asthma attack. We’re urging people with asthma and healthcare professionals to watch Asthma UK’s videos so they feel confident in how people can use their inhalers to stay well.”

For more information and to view the videos, visit www.asthma.org.uk/inhalervideos  


For further information, please contact:

Hannah Jowett, Media Officer – 0207 786 4951 or hjowett@asthma.org.uk

Asthma UK media team – 0207 786 4949 or mediaoffice@asthma.org.uk

Out of hours – 07951 721 393

Notes to Editors

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*Asthma UK surveyed 10,064 people with asthma to ask them if they had had their inhaler technique checked by a GP or asthma nurse in the last year, of which 15% (1,515) said they had not, while 4% (379) said they couldn’t remember. If we combine these figures and apply the percentage (19%) to the asthma population in the UK (5.4 million), we can estimate that 1,026,000 people in the UK have not had their inhaler technique checked.

**Guidelines from the National Review of Asthma Deaths (NRAD) advises that people with asthma have their inhaler technique checked routinely and formally documented at their annual asthma review by their GP or asthma nurse: Royal College of Physicians, May 2014, Why Asthma Kills, p.14, https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills [accessed 13/03/19]

***Exact figure is 45.6%. The study states that a critical error is exhalation technique can “…impact the effectiveness of the delivered drug and thereby lead to the suboptimal disease control of asthma and COPD.”: Henry Chrystyn et al, Device errors in asthma and COPD: systemic literature review and meta-analysis, (April 2017), published in NPJ Primary Respiratory Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434773/ [accessed 20 February 2019]

****Baverstock et al, Do healthcare professionals have sufficient knowledge of inhaler techniques in order to educate their patients effectively in their use, (November 2010), published in Thorax, https://thorax.bmj.com/content/65/Suppl_4/A117.3 [accessed 20 February 2019]

*****Between 01/01/18 and 31/12/18, Asthma UK’s telephone Helpline received 3,055 calls about inhaler technique.

About Asthma UK

  • In the UK, 5.4 million people are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12).
  • Every day, the lives of three families are devastated by the death of a loved one to an asthma attack, and tragically two thirds of these deaths are preventable.
  • Asthma UK’s mission is to stop asthma attacks and cure asthma. We do this by funding world leading research, campaigning for improved care and supporting people to reduce their risk of a potentially life-threatening asthma attack.
  • For more information about asthma please visit www.asthma.org.uk