Chronic obstructive pulmonary disease in older adults part II: Considerations for inhaler selection

Tamara Bystrak, VA Connecticut Healthcare System
Christine Eisenhower, College of Pharmacy


Inhaler administration for patients with chronic obstructive pulmonary disease (COPD) can be challenging, as it requires correct recall and execution of multiple steps. Older adults may have a higher risk of incorrectly administering inhalers versus the general population due to agerelated visual, cognitive, and functional impairments. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018 report states that in addition to advanced age, use of multiple inhalers and lack of previous inhaler education can negatively impact technique. Improper inhaler use can lead to poor disease control, increased acute care utilization, and reduced quality of life. Therefore, regular evaluation of technique is emphasized by the GOLD guidelines to improve patient outcomes. Health care professionals on geriatric interdisciplinary teams can work together to achieve proper technique and evaluate for age-related limitations that may guide the choice of inhalers in older adults with COPD.