Clinicians can help their patients actively transition to and better accept their HFA-propelled albuterol rescue inhalers by initiating a brief but effective intervention during regular consultations. Improper education and miscommunication can lead to confusion, drug misuse, and potentially undesirable health outcomes.
Four Essential Steps to an Active HFA Transition:
- Reassure patients they are receiving the same medicine and same dose as they received with older CFC devices.
- Teach patients about differences they may feel when using an HFA device. Help build their confidence.
- Teach and demonstrate how to properly use the HFA inhaler; do this often.
- Explain the importance of inhaler maintenance, including weekly cleaning for HFA inhalers and when the device should be primed.
It can be helpful for clinicians to explain to their patients the reasons for this change and briefly describe the FDA mandate and the reasons behind it.
Patients should be encouraged to promptly report any difficulties they are having with their new inhalers and/or any change in or exacerbation of symptoms. This can lead to early intervention when faulty inhaler technique or a clogged inhaler is to blame or, in rare cases, where there is an allergic reaction. At asthma follow-up visits, ask patients about how satisfied they are with their medications and ask them to demonstrate how they use their inhaler devices to reinforce proper technique. This may only take a few moments in the office, but encouraging proper technique helps ensure that medication is delivered correctly to the lungs.
Treatment success and patient satisfaction depend on you and the partnerships you build. A short transition intervention with the patient can ultimately lead to better asthma control.
Part of an effective active transition to an HFA albuterol inhaler is briefly describing the differences that patients should understand. The three main points to communicate are: the difference in the medication plume or spray, cleaning the device, and priming the device.
The spray from an HFA inhaler (also called the plume) is different from the spray of a CFC inhaler.
- The spray from an HFA inhaler may feel softer than that from a CFC inhaler. The patient is getting the same amount of medicine with the HFA inhaler; it just has a more gentle delivery.
- The spray from an HFA inhaler may taste different than the spray from a CFC inhaler.
- The spray from an HFA inhaler may feel warmer than the spray from a CFC inhaler. This is because it is sent out of the MDI canister with less force than that of CFC inhalers, and therefore at a warmer temperature.
HFA inhalers may clog easier than CFC inhalers, so it's especially important that your patient clean the inhaler regularly.
- Rinse the mouthpiece of the inhaler under warm running water at least once a week.
- Be sure to shake off any excess water and let the inhaler dry completely after washing it.
HFA inhalers should be "primed" at appropriate times.
- Priming an inhaler includes spraying it into the air a number of times before use.
- Patients need to prime their inhaler before they use it for the first time, if they have not used it in 2 weeks, or if they have dropped it.
- Patients should carefully follow the instructions for priming that come with the specific HFA inhaler.
Patients should always be sure to follow the instructions for using and caring for their HFA inhaler, as well as the directions in the package insert (information leaflet) that come with it.
