OBJECTIVES : - to assess the barriers to and competency with the use of metered dose inhaler and its impact on disease control among adult asthmatic patients.

METHODS : - A cross-sectional prospective study was conducted in University of Gondar comprehensive and specialized hospial outpatient department (OPD) chronic follow up from 12th march 2018 to 15th may 2018. Patients were interviewed face to face with questions which determined their competency, asthma control level and barriers for inhaler use.

RESULTS : - Overall, 307 asthmatic patients were included in the study. More than half of the participants were female, 170(55.4%) and lived in urban area 185 (60.3%). The mean age of the respondants was 51.77 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.

CONCLUSIONS : - 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 MDI use among asthmatic patients. Patients show very poor competence to their MDI which in turn leading 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.