Real-world data on inhalation technique lead by community pharmacies of Spain
Abstract
Background: Inhaled therapy is the cornerstone of chronic obstructive pulmonary disease (COPD) and asthma treatment, but incorrect inhaler handling (up to 90%) has not improved over the past 40 years. We aimed to assess real-life inhaler device handling in COPD and asthma and its association with the pathology control after pharmacist-led intervention.
Methods: A multicentre, longitudinal, observational study was conducted involving children and adults with asthma, COPD and asthma-COPD overlap (ACO). Inhalation errors were assessed across several consecutive visits to the pharmacy using a standardised protocol. Disease control was evaluated through the COPD Assessment Test (CAT), the Asthma Control Test for adults (ACT) and children aged 4–11 (C-ACT). Descriptive, inferential and multiple linear regression analysis were applied.
Results: 2,472 patients were included (1056 COPD, 865 Asthma adults, 83 Asthma kids and 117 ACO) across 104 community pharmacies in 89 cities throughout Spain. Mean handling errors decreased significantly (p < 0.001) from the first visit onwards: in COPD [2.64 to 1.11]; asthma adults [2.32 to 0.67]; asthma kids [2.34 to 0.60]; and ACO [2.91 to 1.86]. Parallel improvements in disease control were observed: COPD CAT (16.04 to 11.67) (p < 0.001), asthma adults progressed from uncontrolled to controlled status (ACT 17.28 to 21.92). Children achieved well-controlled asthma (C-ACT from 18.50 to 23.33). Linear regression analysis found associated the visit number, inhaler device and age to be significant predictors of the inhaler handling errors and pathology control.
Conclusions: Inhaler errors clearly decreased after pharmacist-led intervention, with parallel improvements in disease control of all respiratory conditions studied.
Key messages: • For the first time, real-world evidence clearly shows that pharmacist-led education reduces inhaler technique errors in patients with COPD and asthma, in both adults and children.
• These findings suggest that integrating pharmacist-led educational programs into national health strategies can significantly mitigate the clinical and economic burden of chronic respiratory diseases.
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BibTeX
@article{cordero2026realworld,
title = {{Real-world data on inhalation technique lead by community pharmacies of Spain}},
author = {J A Cordero and M A Via and V Alcaraz and C Lucas and J Vilaró},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1106},
url = {https://doi.org/10.1093/eurpub/ckag169.1106},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Real-world data on inhalation technique lead by community pharmacies of Spain
AU - J A Cordero
AU - M A Via
AU - V Alcaraz
AU - C Lucas
AU - J Vilaró
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1106
UR - https://doi.org/10.1093/eurpub/ckag169.1106
AB - Background: Inhaled therapy is the cornerstone of chronic obstructive pulmonary disease (COPD) and asthma treatment, but incorrect inhaler handling (up to 90%) has not improved over the past 40 years. We aimed to assess real-life inhaler device handling in COPD and asthma and its association with the pathology control after pharmacist-led intervention. Methods: A multicentre, longitudinal, observational study was conducted involving children and adults with asthma, COPD and asthma-COPD overlap (ACO). Inhalation errors were assessed across several consecutive visits to the pharmacy using a standardised protocol. Disease control was evaluated through the COPD Assessment Test (CAT), the Asthma Control Test for adults (ACT) and children aged 4–11 (C-ACT). Descriptive, inferential and multiple linear regression analysis were applied. Results: 2,472 patients were included (1056 COPD, 865 Asthma adults, 83 Asthma kids and 117 ACO) across 104 community pharmacies in 89 cities throughout Spain. Mean handling errors decreased significantly (p < 0.001) from the first visit onwards: in COPD [2.64 to 1.11]; asthma adults [2.32 to 0.67]; asthma kids [2.34 to 0.60]; and ACO [2.91 to 1.86]. Parallel improvements in disease control were observed: COPD CAT (16.04 to 11.67) (p < 0.001), asthma adults progressed from uncontrolled to controlled status (ACT 17.28 to 21.92). Children achieved well-controlled asthma (C-ACT from 18.50 to 23.33). Linear regression analysis found associated the visit number, inhaler device and age to be significant predictors of the inhaler handling errors and pathology control. Conclusions: Inhaler errors clearly decreased after pharmacist-led intervention, with parallel improvements in disease control of all respiratory conditions studied. Key messages: • For the first time, real-world evidence clearly shows that pharmacist-led education reduces inhaler technique errors in patients with COPD and asthma, in both adults and children. • These findings suggest that integrating pharmacist-led educational programs into national health strategies can significantly mitigate the clinical and economic burden of chronic respiratory diseases.
SN - 1101-1262
SN - 1464-360X
ER -