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How to demonstrate HandiHaler technique to your patients

How to use and clean the HandiHaler device

Prepare for your next MUR consultation by learning how to demonstrate the HandiHaler

Demonstrating inhaler technique is an important part of many consultations, such as medicines use reviews, the new medicine service and the chronic medication service.

In C+D's video below, Philip Crilly, pharmacy teaching fellow at Kingston University, demonstrates how to use the HandiHaler device and discusses the content of the demonstration pack.

10 steps for using the HandiHaler

  1. Open the cap
  2. Pull back the mouthpiece
  3. Peel back the foil on the capsule pack to the 'stop' point, remove the capsule and place it in the device chamber
  4. Pull the mouthpiece back until it clicks
  5. Hold the device upright and push the green button on the side – it is important the device is not toppled or shaken as the drug may be lost
  6. Breath out gently (away from the inhaler)
  7. Place the mouthpiece between the teeth and close the lips to create a seal
  8. Breath in slowly and deeply for as long as comfortable (the capsule will rotate in the chamber and make a whistling noise)
  9. Hold the breath for as long as possible, before exhaling. [ADDITION: Then repeat steps 6 through to 9, in order to empty the capsule completely].
  10. Repeat step two, and dispose of the capsule.
Cleaning the HandiHaler

Although the device is often given out on prescription alongside the capsule in a combination pack, patients may subsequently be prescribed the capsule-only pack. It is therefore important that you explain to them how to clean their device – as this should be done at least once a month.

When washing the device, you should advise patients to open the dust cap and mouthpiece, then open the base by lifting the piercing button.

Opening the Handihaler device

Rinse the complete inhaler with warm water to remove any powder.

washing the handihaler device with warm water but not soap

Patients should dry the HandiHaler thoroughly before using it. They can do this by tipping excess of water out on a paper towel and air-dry afterward, leaving the dust cap, mouthpiece and base open.

While cleaning the handihaler device you should leave it to air dry

The device takes 24 hours to air dry, so clean it right after use and it will be ready for the patient's next dose. In addition, the outside of the mouthpiece may be cleaned with a moist – but not wet – tissue.

For more information:

4 Comments

Valentine Trodd, Community pharmacist

Don't forget, you can always demonstrate the use of an inhaler in a friendly informal manner without having to go through the charade of an MUR.

Ilove Pharmacy, Non Pharmacist Branch Manager

But there's no money in that. That sort of behaviour will land you in a disciplinary, followed by a tribunal and eventually the SACK

Sarah Hackney, Hospital pharmacist

The patient information leaflet recommends repeating steps 6-9, as you've put them, "in order to empty the capsule completely". Should we not be counselling our patients in line with the manufacturer's literature?

Kristoffer Stewart, Editorial

Hi Sarah, 

Thanks for your comment. I have amended the article to reflect the patient information leaflet recommendations on that point. 

Kristoffer Stewart, clinical editor

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