Introduction:

Prescribing of inhaled therapy, pMDI technique at hospitalisation and therapy concordance pre-admission remains inadequate. A study by Asthma UK (2010-2013) found over 125,000 asthma prescribing errors and a third of patients with ineffectual inhaler technique.

Aims and objectives:

Identify the adequacy of inhaled therapy prescriptions, pMDI technique and pre-admission inhaler concordance using a questionnaire.

Methods:

Two centre prospective study performed over three months in 2022 at two secondary care hospitals in the UK. Data was obtained from prescriptions including availability of inhalers at 24 and 48 hours and the number of devices. A pMDI technique checklist and assessment of concordance using the Test of Adherence to Inhalers (TAI) was performed by trained practitioners.

Results:

70 patients were recruited (median age = 73, COPD: n=50, asthma: n=20). Inhaled therapy was prescribed correctly in 80%; 54% and 63% had their inhalers supplied within 24 and 48 hours of hospital admission respectively. 69% used two or more different devices on admission. 57% had ?1 critical error with pMDI inhaler use. 71% of patients were graded as ?good adherence? on the TAI questionnaire.

Conclusions:

Inhaled therapy was well prescribed but availability of inhaled devices within 48 hours of admission could be improved. Assessment of pMDI inhaler technique during hospitalisation is recommended. Initiation of combination inhalers for patients using two or more different devices may improve concordance. The TAI was used in an acute setting for the first time but a larger study is needed to evaluate its full potential on hospitalisation.