Switching Inhalers: A Practical Approach to Keep on UR RADAR
Abstract The choice of an inhaler device is often as important as the medication put in it to achieve optimal outcomes for our patients with asthma and/or COPD. With a multitude of drug–device combinations available, optimization of respiratory treatment could well be established by switching device...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-10-01
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| Series: | Pulmonary Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s41030-020-00133-6 |
| _version_ | 1819017963485790208 |
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| author | Alan Kaplan Job F. M. van Boven |
| author_facet | Alan Kaplan Job F. M. van Boven |
| author_sort | Alan Kaplan |
| collection | DOAJ |
| description | Abstract The choice of an inhaler device is often as important as the medication put in it to achieve optimal outcomes for our patients with asthma and/or COPD. With a multitude of drug–device combinations available, optimization of respiratory treatment could well be established by switching devices rather than changing or even augmenting pharmacological or non-pharmacological therapies. Importantly, while notable between-device differences in release mechanism, particle size, drug deposition and required inspiratory flow exist, a patient uncomfortable with their device is unlikely to use it regularly and certainly will not use it properly. Switching requires a careful process and should not be done without patient consent. Switching devices entails several steps that need to be considered, which can be guided using the UR-RADAR mnemonic. It starts with (i) UncontRolled asthma/COPD (or UnaffoRdable device), followed by RADAR: (ii) review the patient’s condition (e.g. diagnosis, phenotype, co-morbidities) and address reasons for suboptimal control (e.g. triggers, smoking, non-adherence, poor inhaler technique) to be ruled out before switching; (iii) assess patient’s skills related to inhalation (e.g. inspiratory force); (iv) discuss inhaler switch options, patient preferences (e.g. size, daily regimen) and treatment goals; (v) allow patients input and use shared decision-making to decide final treatment choice, acknowledging individual patient skills, preferences and goals; and (vi) re-educate to the new device (at minimum, physical demonstration, verbal explanation and patient repetition, both verbally and physically) and prime the patient for the follow-up (i.e. explain the future patient journey, including multidisciplinary work flows with physicians, nurses and pharmacists). |
| first_indexed | 2024-12-21T03:11:52Z |
| format | Article |
| id | doaj.art-6a866494d73c4e498650c5fd1147e429 |
| institution | Directory Open Access Journal |
| issn | 2364-1754 2364-1746 |
| language | English |
| last_indexed | 2024-12-21T03:11:52Z |
| publishDate | 2020-10-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Pulmonary Therapy |
| spelling | doaj.art-6a866494d73c4e498650c5fd1147e4292022-12-21T19:17:57ZengAdis, Springer HealthcarePulmonary Therapy2364-17542364-17462020-10-016238139210.1007/s41030-020-00133-6Switching Inhalers: A Practical Approach to Keep on UR RADARAlan Kaplan0Job F. M. van Boven1Department of Family and Community Medicine, University of TorontoDepartment of Clinical Pharmacy and Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of GroningenAbstract The choice of an inhaler device is often as important as the medication put in it to achieve optimal outcomes for our patients with asthma and/or COPD. With a multitude of drug–device combinations available, optimization of respiratory treatment could well be established by switching devices rather than changing or even augmenting pharmacological or non-pharmacological therapies. Importantly, while notable between-device differences in release mechanism, particle size, drug deposition and required inspiratory flow exist, a patient uncomfortable with their device is unlikely to use it regularly and certainly will not use it properly. Switching requires a careful process and should not be done without patient consent. Switching devices entails several steps that need to be considered, which can be guided using the UR-RADAR mnemonic. It starts with (i) UncontRolled asthma/COPD (or UnaffoRdable device), followed by RADAR: (ii) review the patient’s condition (e.g. diagnosis, phenotype, co-morbidities) and address reasons for suboptimal control (e.g. triggers, smoking, non-adherence, poor inhaler technique) to be ruled out before switching; (iii) assess patient’s skills related to inhalation (e.g. inspiratory force); (iv) discuss inhaler switch options, patient preferences (e.g. size, daily regimen) and treatment goals; (v) allow patients input and use shared decision-making to decide final treatment choice, acknowledging individual patient skills, preferences and goals; and (vi) re-educate to the new device (at minimum, physical demonstration, verbal explanation and patient repetition, both verbally and physically) and prime the patient for the follow-up (i.e. explain the future patient journey, including multidisciplinary work flows with physicians, nurses and pharmacists).https://doi.org/10.1007/s41030-020-00133-6AdherenceAsthmaBrandChangeCOPDCost-effectiveness |
| spellingShingle | Alan Kaplan Job F. M. van Boven Switching Inhalers: A Practical Approach to Keep on UR RADAR Pulmonary Therapy Adherence Asthma Brand Change COPD Cost-effectiveness |
| title | Switching Inhalers: A Practical Approach to Keep on UR RADAR |
| title_full | Switching Inhalers: A Practical Approach to Keep on UR RADAR |
| title_fullStr | Switching Inhalers: A Practical Approach to Keep on UR RADAR |
| title_full_unstemmed | Switching Inhalers: A Practical Approach to Keep on UR RADAR |
| title_short | Switching Inhalers: A Practical Approach to Keep on UR RADAR |
| title_sort | switching inhalers a practical approach to keep on ur radar |
| topic | Adherence Asthma Brand Change COPD Cost-effectiveness |
| url | https://doi.org/10.1007/s41030-020-00133-6 |
| work_keys_str_mv | AT alankaplan switchinginhalersapracticalapproachtokeeponurradar AT jobfmvanboven switchinginhalersapracticalapproachtokeeponurradar |