Have you ever wondered how your doctor decides which is the best way for you to take your asthma medication?
Options include syrups, granules, tablets or capsules that you swallow, or aerosols and powders that you inhale from a metered-dose inhaler (MDI), dry powder inhaler (DPI) or nebulizer. Attaching a valved holding chamber to an MDI allows patients to direct the medicine into the airways by holding it and inhaling at their own speed.
Physicians strive to prescribe medications and devices to patients that are not only effective in controlling asthma but also convenient to their needs and lifestyle. You should be part of the decision process when you tell your asthma specialist or primary care doctor about yourself and how you live.
Here are five patient-focused factors that are part of the decision process:
- Age. This is always an important consideration but especially so with infants, whose airways and lung size are small and breathing rates faster than in older children and adults. National asthma guidelines say children should use a holding chamber when using an MDI because the aerosolized spray comes out faster than most kids can inhale.
- Ability to follow directions. This consideration crosses all age groups and includes when and how to take a particular medication. Even adults may confuse the directions for using MDIs and DPIs.
- Hand-breath coordination. Young children should be able to use an MDI with a holding chamber and mask, but they may not be able to breathe in long enough to use a DPI in a diskus device. Older individuals with asthma or COPD may want to use a holding chamber if they are not able to manage the hand-breath coordination of an MD, or use a DPI or nebulizer. Some DPIs are breath actuated, eliminating the need for a coordinated effort to deliver and inhale the medication. Albuterol is now available in a DPI.
- Where you are going to use it. While most people are able to keep their daily asthma maintenance medications at home, many travel or spend their days on the road or in school. In addition, people with asthma should have their quick-relief bronchodilator inhaler easily accessible, even if their asthma is well controlled. For people on the go, delivery systems need to be convenient, portable and low maintenance. In schools and on the playing field, MDIs with holding chambers offer low cost, convenient and effective delivery of albuterol as either premedication or quick-relief.
- Patient preference and convenience. Your needs and preferences are an important consideration in the final selection of asthma medications and delivery. None of them will help if not used. Talk with your doctor!
To benefit from your medication, it must be taken in the right dose, at the right time and in the right way. Since there can be obstacles to any of these steps, review your Asthma Action Plan at every doctor’s visit. Demonstrate your delivery technique to be sure that you are taking your medication correctly and discuss any problems you may have, including cost and reimbursement that may keep you from using your asthma medications the way you should.