Patients’ perspectives and preferences in the choice of inhalers: the case for Respimat^®or HandiHaler^®

Abstract

Poor inhaler technique hampers the efficacy of drug therapy in asthma and chronic obstructive pulmonary disease. Not only does this affect individual patient care, but it also impacts on the wider health care economics associated with these conditions. Treatment guidelines recommend a systematic approach to drug class selection; however, standardization of inhaler selection is currently difficult owing to the complexity of the interaction between the inhaler device and the patient. Specifically, individual patient preference can influence how successful a treatment is overall. This article reviews inhaler devices from the patient perspective, with a particular focus on the dry powder inhaler HandiHaler® and Respimat® Soft Mist™ Inhaler. It discusses factors that influence device preference and treatment compliance and reviews tools that can aid health care professionals to better match inhaler devices to individual patients’ needs.

The Role of Fixed-Dose Dual Bronchodilator Therapy in Treating COPD

“…57,58 Recommendations for device selection in current guidelines are limited. As device suitability depends on several factors (eg, inhalation technique, Table 3 Overview of Inhaler Devices (Adapted from Bonini and Usmani, 2015 11 ; Scichilone et al, 2015;6 59 Dekhuijzen et al, 2016 60 ) coordination, inspiratory flow; Table 3), 11,59,60 an algorithm has been developed to help identify the most suitable inhaler type for a given patient (Figure 2). 61 A device should be chosen after careful evaluation of the patient's clinical condition, as well as patient preference.…”

Device use errors with soft mist inhalers: A global systematic literature review and meta-analysis

“…COPD patients who are prescribed an SMI typically have suboptimal inspiratory flow and difficulty rapidly coordinating actuation with inhalation. 17,63 Compared to patients using other inhalers, patients using SMIs also tend to be younger, more likely to have severe respiratory disease, and a greater number of comorbidities, particularly neurologic and hypertensive heart diseases. 64 Patients who experience difficulty using an SMI may be candidates for inhalation therapy with other types of devices such as nebulizers.…”

“…6,7,[12][13][14] In addition, patient and caregiver preferences regarding device features and costs can influence selection. 7,[15][16][17] Regardless of inhalation device types and characteristics, the patient's ability to correctly use the device is paramount to successful treatment. 18,19 Numerous studies have shown that incorrect inhalation device technique can compromise medication delivery, increase the risk of exacerbations, result in higher health resource utilization, and lead to premature mortality.…”

The Respimat® Development Story: Patient-Centered Innovation

“…In addition, successful drug delivery to the lungs (as determined by a physician) is associated with patient satisfaction with their inhaler device; satisfaction promotes long-term compliance with respiratory maintenance therapy and is linked to improved clinical outcomes [1,3,[45][46][47]. Assessments conducted during clinical trials and studies using self-report instruments [including simple surveys specific to Respimat Ò , the validated Patient Satisfaction and Preference Questionnaire (PASAPQ) and the Handling Questionnaire (an investigational tool)] have suggested that patients with COPD or asthma find Respimat Ò easy to operate [3,45,[48][49][50][51][52][53] and prefer this inhaler over other types of device, such as pMDIs or DPIs [3,[49][50][51][52]54].…”