Association of depression with improper use of inhaler devices by patients with obstructive disease.
INTRODUCTION
Obstructive pulmonary disease may cause some psychiatric disorders such as depression, similar to other chronic diseases. Patients with chronic obstructive pulmonary disease or asthma are especially susceptible to inhaler technique errors. The aim of this study was to evaluate the depression that can affect improper use of inhaler devices and to show the contribution of age, sex, and education to correct usage.


MATERIALS AND METHODS
In this study, trained health care workers in the presence of Chest specialist requested patients to demonstrate their inhaler technique and assessed it according to the checklist. If any of the steps were missing or done incorrectly, it was marked as an incorrect technique.


RESULTS
We included 188 participants, mean age of 58.3 ± 12.7 years. Significant variables of individual risk were having comorbidities, age, sex, smoking status, and educational level. There was an inverse relationship between education level and incorrect inhaler technique. Even after controlling for age, gender, and education, depressive symptoms were a significant and independent predictor of improper use of inhaler devices. High levels of depressive symptoms were associated with a 22-fold increase (95% confidence interval, 8.9 to 53.5) in the odds of improper use of inhaler devices after adjustment for potential confounders.


CONCLUSIONS
As a result, the presence of depression symptoms may increase the improper use of inhaler devices. Further research is needed to determine if screening for and treating depression improves improper use of inhaler devices and obstructive disease outcomes in this population.
['Bulut|Sertan|S|', 'Karamanli|Harun|H|https://orcid.org/0000-0001-5453-1526', 'Akın Kabalak|Pınar|P|https://orcid.org/0000-0002-4087-7048']
D000280:Administration, Inhalation D003863:Depression D004867:Equipment Design D006801:Humans D007231:Infant, Newborn D009330:Nebulizers and Vaporizers D029424:Pulmonary Disease, Chronic Obstructive
depression obstructive pulmonary disease inhaler technique age