For those with allergies or asthma, epinephrine auto-injectors and asthma inhalers are the first line of defense when symptoms appear. However, research reveals that a majority of patients are not using these life-saving devices properly.
In fact, a 2014 study published in the Annals of Allergy, Asthma and Immunology found only 7 percent of inhaler users and 16 percent of epinephrine users administered their medication perfectly.
“Our study suggests that either people weren’t properly trained in how to use these devices, didn’t completely understand the instructions even after training, or forgot the instructions over time,” said allergist Dr. Rana Bonds, the study’s lead author and an assistant professor at University of Texas Medical Branch. “Younger patients and those with prior medical education were more likely to use the auto-injector correctly.”
Participants were asked to demonstrate how they would administer their auto-injector or inhaler. Researchers observed and compared their technique to established guidelines, scoring participant’s performance of each step as right or wrong.
Researchers found that most of the 102 patients involved in this study made multiple mistakes, missing crucial steps during their demonstration. The following are the most common mistakes of the research participants.
Most common errors with asthma inhalers:
- Not exhaling before delivering the puff of medication. This is necessary in order to empty the lungs and and allow the user to take as deep a breath as possible when the medicine is inhaled.
- Not shaking the inhaler before administering the second puff.
- Not realizing that the horn-type sound from the spacer indicates that the inhalation was not done properly.
Most common errors with epinephrine auto-injectors:
- Not holding the unit in place for at least 10 seconds after injecting. [Note: recommendations have changed since this study. Patients now hold a pen-style auto-injector in place for 3 seconds and an Auvi-Q device for 2 seconds.]
- Not placing the needle end of the auto-injector on the thigh.
- Not pushing down forcefully enough to activate the automatic injection.
Dr. Aasia Ghazi, a co-author on the study, says this research is evidence that there needs to be better education around how to use these devices. “We need to consider repeated verbal instructions as well as more effective visual presentations,” she says.
“Improper use of the devices means people’s lives are at stake, especially with epinephrine, and there is reduced value in the medicine they’re trying to use.”
Resources for using your epinephrine auto-injector or inhaler correctly:
- How to use an Auvi-Q
- How to use an EpiPen
- How to use Impax Laboratories’ generic auto-injector
- How to use Teva generic auto-injector
- How to use different types of asthma inhalers
