Inappropriate use of inhalers
Inhalation step by step:
What your patients SHOULD be doing
Step 1: Remove the cap
from the inhaler.
Step 5: Tilt your head back
slightly.
Step 2: Shake the inhaler
well for 5 seconds.
Step 6: Exhale away from
the inhaler.
Step 3: Hold the inhaler
firmly by placing your index
finger on top of the canister,
and thumb on the bottom of
the mouthpiece.
Step 7: Put the inhaler in
your mouth. Press the
inhaler and start breathing
in at the same time. Take a
slow and deep breath.
http://use-inhalers.com/how-to-use-mdi
Step 4: Sit straight or stand
up.
Step 8: Hold your breath for
10 seconds. Exhale slowly
through your mouth or nose.
Easier to use a spacer
“
Asthma & COPD in the UK
The British Thoracic Society Guidelines/Scottish Intercollegiate Guidelines Network/NICE guidelines provide
evidenced Based Platforms for the management of patients with these conditions. The local health economies within the UK
will only approve funding for specific projects if they meet the quality, innovation, productivity and prevention requirements of
QIPP.
In terms of how this translates to prescribing, within the UK, prescribing follows the guidelines within the
BTS steps 1-5. Over the last 10years, but particularly over the last 5 years there has been an erosion of patients at
step 2 of the BTS guidelines, with patients being established onto step 3 earlier i.e. combination therapy. Step 3
medication is significantly more expensive than step 2 and there are real concerns that patients who could be
managed effectively at step 2 of the BTS guidelines are being initiated onto step 3 therapy and creating a cost burden
to the tax payer.
In addition patients who are controlled at step 3 are not being titrated downward to step 2 as also underlined in the
guidelines.
In many cases the reason for the poor asthma control can be attributed to the fact that a large number of
patients are not taking their preventer therapy regularly or indeed cannot use their pMDI inhaler effectively.
The addition of a spacer device or alternatively a change of inhaler device to another step 2 therapy for these patients
would represent a significant cost saving for the NHS. In particular many localities recognise that pMDIs are
difficult to use and that the addition of a spacer device is an extremely cost-effective intervention to prevent patients
progressing to step 3. Indeed several localities have stipulated that any patient being prescribed a pMDI should
always be co-prescribed a spacer. “
Eddie Mcknight, Managing Director, NSHI Ltd
Spacer Chambers on the market in the UK
The Compact Space Chamber Plus Overview
Oval shaped
mouth piece for
greater comfort
Clear visibility of the valve
moving allowing positive
reinforcement of
medication administration
.
Dishwasher
proof, guaranteed
for 12 months
Fits multiple pMDI
connections due to
flexible rubber
connection, round
and shaped
15 mm ISO
standard
Connection to attach
a tracheostomy
directly
22 mm connection for
standard mask fit
Very Low resistance allows the
valve to open wide allowing aerosol
to pass to the patient on inhalation
Clean life long glass like
polycarbonate body giving a new
look for 12 months
Asthma UK help line
Asthma UK’s Clinical Lead
Deborah Waddell said: “We
know that the Space Chamber
plus® is popular with patients
and clinicians, so we are very
pleased to welcome MDUK to
our corporate partnership
scheme
MDUK is supporting
Asthma UK to bring
improved techniques to
asthma patients.
25p from the sale of
each unit of the Space
Chamber Plus, Combo
Space Chamber Plus,
Compact Space
Chamber Plus and
Combo Compact Space
Chamber Plus will be
donated to Asthma UK,
a registered charity, no.
802364.
The Asthma UK Helpline number is
0800 121 62 44
(open Monday to Friday 9-5pm)
Medical Developments UK (MDUK) has become a silver
corporate partner of Asthma UK, the UK’s leading asthma
charity. As part of the agreement, MDUK will donate 25p to
the charity from the sale of each of its spacers in the UK,
including both the Space Chamber plus® and the Space
Chamber plus Compact ®.
Medical Testimonials
“We were very impressed with the Space
Chamber Plus – with a low resistance valve,
it’s easy to see when the spacer is being
used correctly and it’s very useful to be able
to connect easily to a tracheotomy tube. We
were also pleased to note that this spacer is
dishwasher safe.”
Vicky Taylor
Practice Nurse, Northants
Equivalence in vitro testing
In vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber
Plus Flow Vu™ Anti‐static, and Aerochamber Plus Flow Vu™
Study Objective:
To compare drug output and aerodynamic particle size distribution of combination inhalers, for the treatment of both the bronchoconstriction and
inflammatory aspects of asthma and chronic obstructive pulmonary disease (COPD), when delivered from different valved holding chambers
(VHCs): Space Chamber Plus (SCP), Compact Space Chamber Plus (CSCP), Aerochamber Plus Flow Vu and Aerochamber Plus Flow Vu
Anti‐static.
Conclusion:
Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non‐antistatic valved holding chambers,
Chamber Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Antistatic, and
non‐antistatic Aerochamber Plus Flow Vu. Both Space Chamber Plus and Compact Space Chamber Plus are made of the same materials. The
shorter length of the Compact Space Chamber Plus easily fits into school bags, handbags or briefcases to allow easier storage and handling. Both
VHCs have a transparent body so that the respiratory valves and their movement can be easily seen
and therefore enables the confirmation of correct product operation and usage
In vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber
Plus Flow Vu™Anti‐static
Study Objective:
To compare particle size distribution, and therefore in vitro performance, of three different classes of drug (albuterol sulfate, beclomethasone
Dipropionate and ipratropium bromide) when delivered from three different valved holding chambers (VHCs).
Conclusion:
Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non‐antistatic VHCs, Space Chamber
Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Anti‐static.
Features of the MDI Spacer Chamber ®
•
Unique patented Cross-Valve technologyTM
•
Universal end suitable for all Meter Dose Inhalers
•
Compact design
•
Very low resistance ensures more than 20% respirable
Open
Closed
particle delivery compared to other established spacer products 1
•
Transparent design to allow you to see medication delivery and cross valve
functionality
•
Can be used with any international standard respiratory facemask
•
Enables unrestricted and continuous breathing
•
Deigned with detachable mask to enhance children to move up to without mask
inhalation but with the security of having a mask if needed in one device
•
No whistle as it leads to confusion and misunderstanding in patients
For Use by the old and young,
COPD and Asthma patients