Prevalence and predictors of suboptimal peak inspiratory flow rate in COPD patients

Harb, Hadeer S.; Laz, Nabila Ibrahim; Rabea, Hoda; Abdelrahim, Mohamed

doi:10.1016/j.ejps.2020.105298

Cited by 45 publications

(90 citation statements)

References 30 publications

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“…The association between age and PIF remains controversial. Some works published in the literature have found this association, [5,25,[28][29][30], while other authors have been unable to confirm these findings [19,26,31]. These discrepancies may be because, in reality, in these studies, age acts as a surrogate variable for other more important factors such as the presence of comorbidities or the patient's state of frailty [32].…”

Section: Discussionmentioning

confidence: 90%

“…Previous studies have also reported high prevalence of suboptimal PIF in COPD patients, ranging from 20% to 78% in the populations studied [19,[24][25][26]. These frequencies may vary depending on the population studied, the device used to assess PIF, the IDs assessed and the clinical context, because some of these previous studies were carried out during periods of hospitalization [25].…”

Section: Discussionmentioning

confidence: 93%

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Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Represas-Represas

Aballe-Santos

Fernández-García³

et al. 2020

JCM

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Objective: Although the importance of assessing inspiratory flow in the selection of treatments for chronic obstructive pulmonary disease (COPD) is understood, evaluation of this factor is not yet widespread or standardized. The objective of the present work was to evaluate the peak inspiratory flow (PIF) of patients with COPD and to explore the variables associated with a suboptimal PIF. Methods: An observational, cross-sectional study was carried out at specialized nursing consultations over a period of 6 months. We collected clinical data as well as data on symptoms, treatment adherence, and patient satisfaction with their inhalers via questionnaires. PIF was determined using the In-Check Dial G16® device (Clement Clarke International, Ltd., Harlow, UK). In each case, the PIF was considered suboptimal when it was off-target for any of the prescribed inhalers. The association with suboptimal PIF was evaluated using multivariate logistic regression and the results were expressed as the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 122 COPD patients were included in this study, of whom 34 (27.9%) had suboptimal PIF. A total of 229 inhalers were tested, of which 186 (81.2%) were dry powder devices. The multivariate analysis found an association between suboptimal PIF and age (OR = 1.072; 95% CI (1.019, 1.128); p = 0.007) and forced vital capacity (OR = 0.961; 95% CI (0.933, 0.989); p = 0.006). Conclusions: About a third of patients in complex specialized COPD care have suboptimal PIFs, which is related to age and forced vital capacity.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 93%

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Represas-Represas

Aballe-Santos

Fernández-García³

et al. 2020

JCM

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“…Mistakes were noticed and corrected with the right steps as suggested by ERS/ISAM task force report listed in Table 1 33 . These steps have been used successfully in many other studies 14,24,26‐28,32 . According to the ERS/ISAM task force report suggestions, the MDI inhalation technique was separated into several steps as it was revealed before that this separation of steps may help subjects in improving their inhalation technique as it makes the MDI counselling more operative and permit to easily notice the hard steps 33…”

Section: Methodsmentioning

confidence: 99%

“…Continuous counselling of asthmatics improves their long‐term asthma control and has vital role in the proper managing of various limitations of airflow 16‐18 . It also may increase the pulmonary function tests score, quality of life and asthmatic subjects’ illness 19‐32 …”

Section: Introductionmentioning

confidence: 99%

The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

et al. 2020

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Background Subjects’ improper usage of their metered‐dose inhalers (MDI) is considered a chief cause of poor asthma control. The work presented here aims to evaluate the effect of MDI verbal counselling on subjects’ lung function and inhalation technique. Method A total number of 900 asthmatic subjects (450 female) were gathered from University hospital outpatient clinics from January 2017 to May 2019 with a mean (SD) age 45.2 (17.1) years old. They were divided into two groups. The first was monthly asthma follow‐up, for three visits, (450 (266 females) subjects). The other group was monthly asthma follow‐up, for three visits plus MDI inhalation technique verbal counselling (450 (184 female) subjects). At the beginning of studying group 2 and at every monthly visit (three visits), each subject was asked to show the investigator his MDI inhalation technique and the number of mistakes was noticed and adjusted. Additionally, at each visit, their forced expiratory volume in one second (FEV1) as a percentage of the forced vital capacity (FVC) and peak expiratory flow (PEF) were measured. Results No subject dropped out from group 2; however, 95 subjects dropped out from group 1 with no improvement in the lung function tests. The mean number of accurate steps of the MDI inhalation technique observed in group 2 was improved significantly (P < .001) as the number of visits increased particularly in children. “Start to inhale slowly, through the mouth and at the same time press the canister to actuate a dose and maintain a slow and deep inhalation, through the mouth, until the lungs are full of air (This should take an adult 4‐5 seconds)” was the common repetitive mistake. There was a significant improvement (P < .05) in the lung function test scores after the counselling in group 2, especially in old subjects. Conclusions MDI’s counselling must be continually offered to the asthmatic subject at any possible chance to improve and sustain the optimal MDI inhalation technique and probably improve subjects’ lung function score.

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“… 47 Suboptimal PIF is associated with exacerbations and hospital readmissions. 48 Routine assessment of PIF could optimize inhaler selection and consequently improve clinical outcomes 49 ; this is a role that can be fulfilled by pharmacists. Pharmacists’ knowledge of inhaler technique can be instrumental in optimizing inhaler competency and medication adherence, thorough patient education, demonstration of inhaler use, and follow-up.…”

Section: Treatment Adherence and Correct Inhaler Usementioning

confidence: 99%

Emerging role of pharmacists in managing patients with chronic obstructive pulmonary disease

Hudd

2020

American Journal of Health-System Pharmacy

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Prevalence and predictors of suboptimal peak inspiratory flow rate in COPD patients

Cited by 45 publications

References 30 publications

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

Emerging role of pharmacists in managing patients with chronic obstructive pulmonary disease

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