Men and married people are more likely to use an inhaler to treat their respiratory condition properly, a local study has confirmed.

The objective of the study – which found that three-quarters of people do not use the device properly – was to determine what predicts the correct use of inhalers.

About 15 per cent of the Maltese population suffer from asthma, which is treated mainly through inhaling medicine, by cutting down on smoking and avoiding allergens. Those suffering from chronic obstructive pulmonary diseases also use inhalers.

A group of 208 people from Mater Dei Hospital and the community were interviewed for the study, which focused on 12 important steps that are required for the proper use of inhalers.

Nearly a quarter of the patients (23 per cent) used an inhaler properly and adhered to all 12 steps. The majority, however, managed nine out of 12 steps.

Unfortunately, the three steps that were the more skipped or carried out incorrectly were all critical: shake the inhaler well for five seconds, exhale completely away from the inhaler or the spacer, and hold your breath for 10 seconds or as long as is comfortable.

According to the study, men were more than twice as likely to complete at least 10 steps correctly, and so were those who have received the pneumococcal vaccine.

The jab, which protects against chest infection, has to be bought by the patients themselves, reflecting a higher motivation to look after oneself, respiratory physician Martin Balzan, who led the study, explained.

Meanwhile, married people were nearly twice as likely to complete the critical steps. Partner support has been shown to help with the patient’s compliance to cure, Dr Balzan explained.

The study also shows that those whose respiratory physician showed them how to carry out the procedure were nearly four times as likely to complete all 12 required steps.

It appears in Malta, such physicians are spending nearly twice as much time to explain the procedure than general practitioners.

Still, although only half of the interviewees had their GP explain the procedure to them, these patients were three times more likely to follow the procedure.

Previous studies had already proven that a large proportion of patients are unable to use their inhaler devices properly and this, of course, compromises the efficacy of this treatment.

Dr Balzan explained that if medicine ended up in the patient’s mouth or throat, rather than their lungs, they could remain symptomatic and even end up hospitalised.

Dr Balzan was part of the team of researchers for the study, authored by Kyra Bartolo, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon and Stephen Montefort.

The findings of the study were published by BMC Pulmonary Medicine – a peer-reviewed open access journal.

Steps for good inhaler use

• Remove cap;
• Shake inhaler well for five seconds (critical step);
• Hold inhaler firmly;
• Sit up straight or stand up;
• Tilt head back slightly;
• Exhale completely away from inhaler (critical step);
• Place inhaler in mouth and seal lips around it;
• Press inhaler and breathe in steadily and deeply (critical step);
• Remove inhaler from mouth;
• Hold breath for 10 seconds or as long as comfortable (critical step);
• Exhale slowly;
• Replace cap.