Establishment of relationships between native and inhalation device specific spirometric parameters as a step towards patient tailored inhalation device selection

Abstract

ResultsMore than 60% of the patients stated that their current device is the easiest to use. The means of the measured PIFdev values were 91.4 L/min, 77.1 L/min and 77.5 L/min for Breezhaler ® , Genuair ® , and Turbuhaler ® , respectively. PIFdev were significantly higher for males than for females, but differences upon age, BMI and disease severity group were not significant (at p=0.05). Peak inspiratory flows through the inhalers (PIFdev) correlated best with their native spirometric counterparts (PIF) and linear PIFdev-PIF relationships could be determined (Breezhaler ® : r=0.60, p=0.002, Genuair ® : r=0.55, p=0.001, Turbuhaler ® : r=0.57, p=0.002). Physical background of the deduced equations was also provided. ConclusionsPresent correlations may be used to assess the success of inhalation of COPD patients through the studied devices and to choose the appropriate device for each patient. As a consequence, the amount of the drug emitted by the device can be optimized, the deposition efficiency within the lungs increased and the related therapeutic effect improved.

Measuring Peak Inspiratory Flow in Patients with Chronic Obstructive Pulmonary Disease

“…In a few studies, instructions were in line with patient information leaflets/Instructions for Use brochures. 7,51,53,56,59,62,68,71,72,74 In other studies, the instructions were not consistent with the Instructions for Use leaflet for the DPI being evaluated. 76,79 The contents of the Instructions for Use of the In-Check™ DIAL were consistent with instructions provided to patients using DPIs in one study 58 but not in others.…”

“…Overall, the PIF measurement details, including inhalation instructions, were provided or participants were referred to patient information leaflets in 35 of the 47 studies (74.5%; Supplementary Table 1). 7,12,[21][22][23]26,[32][33][34]48,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]68,[70][71][72][74][75][76]78,79 Instructions for exhalation before the inhalation maneuver were provided in 14 (29.8%) studies and included "exhale gently to FRC," 12,26,60,66 "complete exhalation," 21,23,57,74 "exhale to RV," 60,75 "deeply A gentle tap will dislodge the magnetic resetting weight, which will return the red cursor to a start position. When this has happened, the meter must turn through 180 degrees to return the magnetic weight to its resting positio...…”

Relationship between Peak Inspiratory Flow and Patient and Disease Characteristics in Individuals with COPD—A Systematic Scoping Review

“…More details on data charting for all of the papers included in the systematic scoping review can be found in Supplementary Table S4. [11,17,21,22,25,28,30,32,34,3 5,44,47] Age ↑; PIF ↓ 1 (r ranging from −0.19 to −0.84; odds ratio ranging from 1.05 to 1.07) 5/17 (29%) [18,19,29,36,46] Gender 14/35 10/14 (71%) [16][17][18][19]22,26,32,35,36,47] Female gender; PIF ↓ 2 (odds ratio ranging from 0.28 to 2.41)…”

“…4/14 (29%) [11,21,29,34] Height 11/35 8/11 (73%) [16][17][18][19]22,28,32,44] Height ↓; PIF ↓ 3 (r ranging from 0.26 to 0.44) 3/11 (27%) [11,25,35] Age ↑; PIF ↓ 1 (r ranging from −0.19 to −0.84; odds ratio ranging from 1.05 to 1.07) 5/17 (29%) [18,19,29,36,46] discussed or controlled for, thus scoring negatively.…”

“…More details on data charting for all of the papers included in the systematic scoping review can be found in Supplementary Table S4. [16][17][18][19]22,28,32,44] Height ↓; PIF ↓ 3 (r ranging from 0.26 to 0.44) 3/11 (27%) [11,25,35] 10/14 (71%) [16][17][18][19]22,26,32,35,36,47] In the studies included in this analysis, PIF refers to maximal inspiratory flow generated during a real or simulated inhaler maneuver. The cut-off for suboptimal/low and optimal PIF varied between studies (if reported).…”