Delivering orally inhaled medications to the older patient with COPD and/or asthma: A challenge in both device design and clinical approach

Challenges associated with adherence to prescribed medication are compounded by the possibility that the older patient, as well as having multi-morbidities, may lack manual dexterity due to commonly encountered diseases such as arthritis or Parkinsonism. The patient may have cognitive difficulties to a varying extent, and as a result is likely to be difficult to be taught correct inhaler technique in the first place, or may likely forget whatever training was received by the prescribing clinician or pharmacist. The demographics in most developed countries mean that a greater proportion of the population will be reaching older age in the next 25-50 years. It behooves those involved in the development of new inhaled products to pay particular attention to the human factors associated with device use. The prescribing clinician and pharmacist need to be aware of the key issues that should be addressed when helping the older patient use, and continue to use, inhaler(s) correctly.