Knowledge, Attitude, and Practice Regarding Inhaler Use in COPD: Determinants, Misconceptions, and Association with Critical Inhaler Errors

Dr. Selva Nandha Kumaran K K¹, Dr. Ghanshyam Verma², Dr. Veena Charishma RP^3*

^1,2,3 Sree Balaji Medical College & Hospital, Chrompet, Chennai, Tamil Nadu, India.

^3* Senior Resident, Department of Respiratory Medicine, Sree Balaji Medical College & Hospital, Chromepet, Chennai, Tamil Nadu, India. (Corresponding Author)

Received: 20th Feb, 2026 | Revised: 4th Mar, 2026 | Accepted: 25th Mar, 2026 | Available Online: 10th Apr, 2026

ABSTRACT

Background: Correct inhaler use is essential for optimal management of chronic obstructive pulmonary disease (COPD), yet inadequate knowledge, attitude, and practice (KAP) contribute to poor treatment outcomes.

Objectives: To assess inhaler-related KAP among COPD patients, identify determinants of poor KAP, and evaluate its association with critical inhaler errors.

Methods: This cross-sectional study included 202 COPD patients attending outpatient and inpatient services of a tertiary care center. A rapid 12-item KAP questionnaire and a device-specific checklist were used to assess inhaler-related KAP and critical inhaler errors. Associations were analyzed using Chi-square tests and multivariate logistic regression.

Results: Poor knowledge and poor inhaler practices were observed in 54.5% and 61.4% of patients, respectively. Critical inhaler errors were identified in 57.4%. Poor inhaler practice independently predicted critical errors (adjusted OR 4.12; p < 0.001).

Conclusion: Poor inhaler practices are common in COPD and strongly associated with critical inhaler errors. Routine technique assessment and targeted inhaler education are essential to improve COPD management.

Keywords: Chronic obstructive pulmonary disease; Inhaler technique; Knowledge attitude practice; Critical inhaler errors; Patient education.

How to cite this article: Selva Nandha Kumaran KK, Ghanshyam Verma, Veena Charishma RP. Knowledge, Attitude, and Practice Regarding Inhaler Use in COPD: Determinants, Misconceptions, and Association with Critical Inhaler Errors. Int J Drug Deliv Technol. 2026;16(4):496-503. DOI: 10.25258/ijddt.16.4.50

Source of support: Nil.

Conflict of interest: The authors declare no conflict of interest.