The University of Huddersfield’s School of Applied Sciences has been carrying out key research into how people use inhalers and the difficulties they encounter. A team of researchers led by Professor Henry Chrystyn has developed new understanding of issues affecting millions of people globally on a daily basis, by mimicking how patients use metered dose inhalers and dry powder inhalers. Their findings have been used to inform the publication of gold standard guidelines that are now influencing practice and policy both nationally and internationally.

What was the problem?

Up to 300 million people suffer from asthma, including more than 5.2 million in the UK, a fifth of them children. Chronic obstructive pulmonary disease (emphysema and chronic bronchitis) represents a similar problem, with approximately 3 million patients in the UK. Inhalers are the primary form of treatment, yet many patients experience problems using them. The main cause of chronic obstructive pulmonary disease is smoking.

Benefits of this research

Crucially, this research has identified that patients use inhalers in different ways; they have a variation of inhalation characteristics. The findings of these studies have been used to inform national and international guidelines on how to train patients to use their inhalers. As well as improving the lives of those suffering from asthma and respiratory diseases, the findings have revealed that the traditional focus on peak inhalation flow when using dry powder inhalers is not as important as other aspects of a patient’s inhalation manoeuvre during inhaler use.

What did we do?

Studies on dose emission from inhalers have in the past often focused on laboratory-based experiments and case studies using patients well-practiced in the use of inhalers. These two methods have provided limited useful insight, but do not accurately reflect the difficulties experienced by average inhaler users in a real-life setting. Researchers at Huddersfield have aimed to overcome all of these shortcomings, using Huddersfield’s comprehensive and highly competitive inhalation therapeutics laboratory, to use a patient’s inhaler technique to objectively identify the characteristics of the dose they would have received.

What happened next?

Chrystyn and his colleagues were involved in a £2.1m National Institute for Health Research Technology Assessment project to identify the synergy between low-dose oral theophylline and inhaled corticosteroids at seven UK clinical excellence centres.

Professor Henry Chrystyn, leading Huddersfield’s research into optimising inhalation techniques, has been heavily involved in developing gold standard clinical guidance.
Chrystyn was a member (and leading author) of the joint European Respiratory Society/International Society of Aerosols in Medicine Task Force that produced consensus guidelines in 2011 for all healthcare professionals on the use of inhalers. This multidisciplinary collaboration has provided clear, up-to-date recommendations that enable prescribers to choose the aerosol delivery device most suitable for their patients and to ensure their patients can use these devices correctly.