Asthma Management Handbook
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Table. Considerations when choosing inhaler devices for older patients

Problem

Solution

Reduced maximal inspiratory flow

Consider pMDI alone or with spacer

Avoid dry-powder inhalers

Reduced manual dexterity (e.g. due to osteoarthritis)

Consider a Haleraid with a pMDI, where relevant (salbutamol, fluticasone, fluticasone/salmeterol)

Consider pMDI with small-volume spacer or breath-actuated dry-powder inhaler

Inability to coordinate actuation and inhalation

Consider pMDI with spacer, breath-actuated pMDI or breath-actuated dry-powder inhaler

Avoid pMDI without spacer

Inability to form effective seal with lips around mouthpiece

Use spacer plus face mask

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