Cognitive Load-Induced Inhaler Errors in COPD: Linking Dual-Task Mobility to Treatment Self-Management
This study evaluates whether cognitive load affects inhaler technique in adults with chronic obstructive pulmonary disease (COPD). During a single study visit, participants will complete assessments of cognitive function, mobility, and respiratory status. Dual-task mobility will be assessed using the Timed Up and Go test performed alone and while completing a cognitive task. Inhaler technique will then be evaluated in two conditions: usual inhaler use without an additional task and inhaler use while maintaining a short sequence of digits in working memory. Inhaler technique will be scored using a standardized five-step device-specific checklist, and inhaler use time will also be recorded. The study will examine whether inhaler technique worsens under cognitive load and whether this deterioration is associated with dual-task mobility performance, cognitive function, respiratory symptoms, and functional capacity. No inhaler training or correction will be provided between the two inhaler conditions. All assessments are performed during a single visit.
• Adults aged 18 years or older
• Confirmed diagnosis of chronic obstructive pulmonary disease (COPD)
• Clinically stable at the time of assessment
• Current use of at least one handheld maintenance inhaler (pMDI, SMI, or DPI)
• Able to understand and follow study instructions
• Able to perform the Timed Up and Go test
• Able to complete the cognitive tasks and inhaler technique assessment
• Able and willing to provide written informed consent