BACKGROUND Asthma is one of the chronic diseases which affects the airway, and inhalers are the preferred medications to treat this problem. Improper inhalational technique leads to decreased efficacy of the medication by reducing its deposition in the lungs. The aim of this study was to assess the barriers to and competency with the use of Metered Dose Inhaler (MDI) and its impact on disease control among adult asthmatic patients. METHODS A prospective cross-sectional study was conducted in University of Gondar comprehensive specialized hospital outpatient department (OPD) chronic follow up from 12-March-2018 to 15-May- 2018. Patients were interviewed face to face with questions which determined their competency, asthma control level and barriers for inhaler use. RESULT Overall, 307 asthmatic patients were included in the study. More than half of participants were females, 170 (55.4%) and lived in urban area 185 (60.3%). The mean age of the respondents was 51.77 years with a standard deviation of ±15.40. The cost of medication, 282 (91.9%) and the perception that medication should be used in response to symptoms but not on a regular basis 277 (90.2%) were the most identified barriers. Only 56 (18.2%) were competent for Metered Dose Inhaler use (MDIU) and 17 (5.5%) patients had well controlled asthma. Being not competent AOR 0.168[0.41-0.687] was one of the factors decreasing asthma control. CONCLUSION Generally from this study, cost of the medication and the perception that medication should be used only for symptoms were the major identified barriers that affect the MDI use among asthmatic patients. Patients show very poor competence to their MDI which in turn led to poor asthma control. So, patients need to be taught the correct inhaler technique in the hospital and pharmacy while they came for follow up every time.

中文翻译：

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埃塞俄比亚成年哮喘患者使用计量吸入器的障碍和能力及其对疾病控制的影响。

背景技术哮喘是影响气道的慢性疾病之一，并且吸入器是治疗该问题的优选药物。吸入技术不当会降低药物在肺部的沉积，从而导致药物功效下降。这项研究的目的是评估使用剂量吸入器（MDI）的障碍和能力及其对成年哮喘患者疾病控制的影响。方法在Gondar大学综合专科医院门诊（OPD）进行了一项从2018年3月12日至2018年5月15日的长期随访的前瞻性横断面研究。患者面对面地接受访谈，以确定其能力，哮喘控制水平和吸入器使用障碍。结果总体上，本研究包括307名哮喘患者。一半以上的参与者是女性，170人（55.4％），居住在城市地区185人（60.3％）。受访者的平均年龄为51.77岁，标准差为±15.40。最容易发现的障碍是药物治疗成本282（91.9％），以及对症状应采取药物治疗而不是定期治疗的看法277（90.2％）。只有56名（18.2％）可以使用计量吸入器（MDIU），而17名（5.5％）的患者哮喘得到了很好的控制。不能达到AOR 0.168 [0.41-0.687]是降低哮喘控制的因素之一。结论总体而言，根据这项研究，已确定影响哮喘患者MDI使用的主要障碍是药物的成本以及仅应针对症状使用药物的观念。患者对他们的MDI表现出非常差的能力，进而导致哮喘控制不佳。因此，在每次随访时都需要在医院和药房里教给患者正确的吸入器技术。