Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates

Abstract Background Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescr...

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Main Authors: Jens Schreiber, Tina Sonnenburg, Eva Luecke
Format: Article
Language:English
Published: BMC 2020-08-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12890-020-01246-z
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author Jens Schreiber
Tina Sonnenburg
Eva Luecke
author_facet Jens Schreiber
Tina Sonnenburg
Eva Luecke
author_sort Jens Schreiber
collection DOAJ
description Abstract Background Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors. Methods Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer. Results Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p = 0.002) and COPD vs. asthma patients (p = 0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance. Conclusions Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.
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spelling doaj.art-9907a4dfc8c34574a12233f74c37fccb2022-12-21T20:31:49ZengBMCBMC Pulmonary Medicine1471-24662020-08-0120111210.1186/s12890-020-01246-zInhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error ratesJens Schreiber0Tina Sonnenburg1Eva Luecke2Department of Pneumonology, Otto-von-Guericke UniversityDepartment of Pneumonology, Otto-von-Guericke UniversityDepartment of Pneumonology, Otto-von-Guericke UniversityAbstract Background Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors. Methods Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer. Results Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p = 0.002) and COPD vs. asthma patients (p = 0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance. Conclusions Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.http://link.springer.com/article/10.1186/s12890-020-01246-zAsthmaCOPDDevice handlingInhaler errorsInhaler techniquePatient preference
spellingShingle Jens Schreiber
Tina Sonnenburg
Eva Luecke
Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
BMC Pulmonary Medicine
Asthma
COPD
Device handling
Inhaler errors
Inhaler technique
Patient preference
title Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
title_full Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
title_fullStr Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
title_full_unstemmed Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
title_short Inhaler devices in asthma and COPD patients – a prospective cross-sectional study on inhaler preferences and error rates
title_sort inhaler devices in asthma and copd patients a prospective cross sectional study on inhaler preferences and error rates
topic Asthma
COPD
Device handling
Inhaler errors
Inhaler technique
Patient preference
url http://link.springer.com/article/10.1186/s12890-020-01246-z
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AT evaluecke inhalerdevicesinasthmaandcopdpatientsaprospectivecrosssectionalstudyoninhalerpreferencesanderrorrates