Dose counting and use of short-acting beta-agonist inhalers in emergency department patients with asthma exacerbation

Medication non-adherence in asthma is a well-recognized problem.1 Non-adherence includes asthma patients using run-out (empty) inhalers and incorrect inhaler techniques.2 These lead to suboptimal disease control and asthma-related emergency department (ED) visits that are potentially preventable.2 Indeed, studies have shown that patients with asthma commonly overestimate the remaining doses of their short-acting beta-agonist (SABA) in metered-dose inhalers (MDIs).3,4 Overestimating the remaining doses of SABA can cause patients to use inhalers beyond the labeled number of actuations, when the drug delivered per actuation can range from 20% to 80% of the therapeutic dose.

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