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ISRN Allergy
Volume 2013 (2013), Article ID 102418, 17 pages
Review Article

The Challenge of Delivering Therapeutic Aerosols to Asthma Patients

Department of Experimental and Clinical Medicine, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy

Received 16 May 2013; Accepted 23 June 2013

Academic Editors: G. Nicolini and F. Ram

Copyright © 2013 Federico Lavorini. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.