Evaluation of inhaler technique and patient satisfaction with fixed-combination budesonide/formoterol dry-powder inhaler in chronic obstructive pulmonary disease (COPD): data on real-life clinical practice in Turkey

Öztürk, Can; Kaya, Akın; Bilgin, Cahit; Yücesoy, Leyla; Ikidag, Belgin; Demirel, Mustafa; Başlılar, Şeyma; Şaylan, Bengü; Senol, Tuncer; Ağanoğlu, Semih; Can, Gonca; Doğrul, Mustafa Ilgaz; Çam, Murat; Erdogan, Nezaket; Batum, Özgür; Turan, Muzaffer Onur; Demir, Cahit; Torun, Şerife; Cirit, Murat; Turan, Mustafa; Keleşoğlu, Arif; Yaşar, Savaş; Uzunay, Oznur; Melek, Kevser; Altiparmak, Osman

doi:10.5578/tt.4634

Cited by 15 publications

(3 citation statements)

References 13 publications

(26 reference statements)

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“…The multicentre character minimized the potential selection bias and allowed a better geographical representativeness. The FSI-10 questionnaire has been previously validated for Asthma and COPD [24,25], though it does not account for the determination of a minimally important difference [13]. Still, the results herein obtained have shown that both inhalers were well accepted by the patients, the mean score of all FSI-10 items was ≥4.0, with at least statistical significant differences favouring Breezhaler ® (a difference of 1.6 out of 50 points between devices).…”

Section: Discussionmentioning

confidence: 70%

Evaluation of the preference, satisfaction and correct use of Breezhaler® and Respimat® inhalers in patients with chronic obstructive pulmonary disease – INHALATOR study

Oliveira

Pizzichini

Costa

et al. 2018

Respiratory Medicine

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The INHALATOR study was a randomized, multicentre, open label, two-period of 7 days each, crossover study, with 7 days of washout in-between, aiming to evaluate the correct use, satisfaction and preference between Breezhaler ® and Respimat ® devices in patients under daily use of open Spiriva ® or open Onbrize ® , as monotherapy for treatment of mild or moderate COPD. Patients aged ≥40 years with a smoking history of at least 10 packyear were included in the study. Primary endpoint was the rate of correct use of each device at the first day of treatment after reading the drug leaflet information and was evaluated under the supervision of a trained evaluator. At the end of each treatment phase, the inhaler use was re-evaluated and a satisfaction questionnaire was completed. The patients' preference for the inhaler devices was assessed at the end of the study. After exclusions due to screening failures, 140 patients were randomized: 136 received at least one dose of Breezhaler ® and 135 of Respimat ® . At treatment start, the rate of correct inhaler use was 40.4% (95%CI: 32.2%-48.7%) for Breezhaler ® and 36.3% (95%CI: 28.2%-44.4%) for Respimat ® (p = 0.451). After 7 days, the rates were 68.9% (95%CI: 61.1%-76.7%) and 60.4% (95%CI: 52.2%-68.7%), respectively (p = 0.077). According to the Feeling of Satisfaction with Inhaler Questionnaire -FSI 10 patients were more satisfied using Breezhaler ® than Respimat ® and 57.1% preferred using Breezhaler ® (p = 0.001) while 30.1% preferred Respimat ® (p < 0.001).

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Section: Discussionmentioning

confidence: 70%

Evaluation of the preference, satisfaction and correct use of Breezhaler® and Respimat® inhalers in patients with chronic obstructive pulmonary disease – INHALATOR study

Oliveira

Pizzichini

Costa

et al. 2018

Respiratory Medicine

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“… 9 However, there are inconsistent results with regard to whether age is related to the incorrect use of inhalers. 9 , 19 , 20 Öztürk et al 20 demonstrated that handling errors were especially common in the older group (≥65 years). The mean age of the patients enrolled in the current study was 72.10±8.98 years, and age was not associated with incorrect inhaler techniques ( Tables 2 and 4 ).…”

Section: Discussionmentioning

confidence: 99%

Misuse of inhalers among COPD patients in a community hospital in Taiwan

Liang¹,

Chen²,

Sheu³

et al. 2018

COPD

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PurposeRespiratory inhalers, which directly deliver medication to the airway, are important for controlling symptoms and preventing exacerbations of chronic obstructive pulmonary disease (COPD). The inhaler misuse rate of patients with COPD in Taiwan is unclear. In this study, the inhaler techniques and patient characteristics associated with incorrect inhaler techniques among patients with COPD were evaluated.Patients and methodsThis cross-sectional study enrolled 298 patients with COPD (mean age 72.10 years) who used at least one inhaler device. The following five types of inhalers were included: metered-dose inhaler (MDI) with spacer, Diskus®, Turbuhaler®, Respimat®, and Breezhaler®. The inhaler technique was evaluated step by step. Misuse of an individual inhaler was defined as an error in at least one step. The sociodemographic characteristics, vision, hearing ability, type and number of inhalers, and inhaler-related knowledge of these patients were recorded.ResultsThe misuse rates of the five types of inhalers ranged from 65.00% to 87.89%. The Respimat inhaler was the most likely to be assembled incorrectly. The steps that were most commonly performed incorrectly were “breathing out fully” and “holding breath”. In the logistic regression analysis, poor hearing was related to misuse of the MDI with spacer (adjusted odds ratio [aOR] 9.85; 95% CI 1.40–69.30); the number of acute exacerbations was related to misuse of Breezhaler (aOR 4.07; 95% CI 1.50–11.08). Incorrect inhaler-related knowledge was significantly associated with misuse in handling the MDI with spacer (aOR 9.58; 95% CI 2.14–42.80), Respimat (aOR 5.14; 95% CI 2.07–12.76), and Breezhaler (aOR 6.98; 95% CI 1.95–25.08).ConclusionThe misuse rates were high for all five types of inhaler. Poor hearing and the number of acute exacerbations were device-specific factors related to the misuse of inhalers. Inhaler-related knowledge was significantly associated with misuse, emphasizing the importance of inhaler education.

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“…Education level was described to impact inhaler technique, although this remains a subject of debate [10]. A low educational level was shown to negatively impact the use of an inhaler in several studies [64,67,68,[72][73][74][75][76], but was not confirmed in others [77][78][79][80]. Interestingly, Pun et al [81] found a correlation between the educational level and the correct use of the Rotahaler ® DPI, but this correlation was not found for a pMDI.…”

Section: Education Levelmentioning

confidence: 99%

Patient Characteristics to Consider When Selecting an Inhaler for the Treatment of Chronic Obstructive Pulmonary Disease and Available Assessment Methods: A Narrative Review

Renaud,

Suter,

Grandmaison

2023

Respiration

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Inhaler misuse is common among patients with chronic obstructive pulmonary disease and associated with poor disease control. Many patient characteristics are reported to impact inhaler use, but there are no studies in the literature on the best way to evaluate them. This narrative review aims to identify patient characteristics that influence the correct use of an inhaler and describe the tools available for their assessment. First, we searched four different databases to identify reviews describing patient characteristics reported to impact inhaler use. In a second step, ways to characterize these aspects were searched using the same databases. Fifteen patient characteristics impacting on the use of inhalers were identified. Peak inspiratory flow, dexterity, and cognitive impairment were the most studied characteristics and appeared to have the highest impact on the correct use of inhalers. Notably, peak inspiratory flow can be reliably assessed in clinical practice using the In-Check Dial<sup>®</sup>. Triggering coordination, breath retention, collaboration/consciousness, and muscle strength in the fingers were important characteristics, but insufficient data exist to recommend the use of a specific tool for their assessment in daily practice. Other identified characteristics have a more uncertain impact. A demonstration of inhalation technique by the patient, combined with the measurement of peak inspiratory flow using the In-Check Dial<sup>®</sup>, appears to be an effective strategy to assess the characteristics with the highest impact on the correct use of an inhaler. In the future, “smart” inhalers could also play a decisive role in this area.

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Evaluation of inhaler technique and patient satisfaction with fixed-combination budesonide/formoterol dry-powder inhaler in chronic obstructive pulmonary disease (COPD): data on real-life clinical practice in Turkey

Cited by 15 publications

References 13 publications

Evaluation of the preference, satisfaction and correct use of Breezhaler® and Respimat® inhalers in patients with chronic obstructive pulmonary disease – INHALATOR study

Evaluation of the preference, satisfaction and correct use of Breezhaler® and Respimat® inhalers in patients with chronic obstructive pulmonary disease – INHALATOR study

Misuse of inhalers among COPD patients in a community hospital in Taiwan

Patient Characteristics to Consider When Selecting an Inhaler for the Treatment of Chronic Obstructive Pulmonary Disease and Available Assessment Methods: A Narrative Review

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