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Inhaler problems in elderly

The great majority of elderly patients with COPD are unable to use their inhalers adequately, a new study reports.

The results, published online by Age and Ageing, suggest many patients under GP care are not actually receiving their prescribed doses of medication.

Patients were in most cases unable to generate sufficient peak inspiratory flow to use their inhalers effectively, with the required flow only reached in patients with mild disease.

In 53 patients who were using metered dose inhalers in primary care, 46 per cent reported they found them difficult to use. Only just over half could detect any clinical benefit.

Study leader Dr Robert Shiner, clinical lecturer in respiratory medicine at Imperial College London, said: 'Even in a clinic setting, the minimum peak inspiratory flow was barely achieved in many cases. It's likely that at home patients will not generate an adequate flow.

'Since some patients with mild COPD may be treated

solely in the community, these findings have important implications for GPs.'

Dr Tony Crockett, a GP in Shrivenham, Wiltshire, and a hospital practitioner in asthma and COPD, said people with COPD tended to have better

inhaler technique than those with asthma, but added: 'You need to be very cautious in

selecting appropriate inhalers for the individual.'

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