Patient Perception and Acceptability of Multidose Dry Powder Inhalers: A Randomized Crossover Comparison of Diskus/Accuhaler with Turbuhaler

Serra-Batllés, Joan; Plaza, Vicente; Badiola, Carlos; Morejón, Elena

doi:10.1089/08942680252908584

Cited by 77 publications

(56 citation statements)

References 8 publications

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“…Another randomized crossover study that compared Diskus® and Elpenhaler® device use and included 113 COPD and Asthma patients naive to both inhalers has shown that after reading only PILs 16.8% of Diskus® and 35.4% of Elpenhaler® users made at least one critical error, while the respective percentages after first instruction by the trainer decreased at both patient groups, reaching 1.8% and 11.5% for Diskus® and Elpenhaler® users, respectively [13]. The value of training of inhalation technique is further confirmed by the results of another randomized crossover study that assessed the use of Diskus®/Accuhaler® and Turbuhaler® devices, after PIL reading only and after inhaler education [14]. The results showed that the percentage of correct handling maneuvers and the percentage of patients achieving 100% of correct maneuvers increased significantly after inhaler education in both tested devices.…”

Section: Introductionmentioning

confidence: 70%

Critical Steps: A Non-Interventional, Multicenter, Prospective, Observational Study on Critical Handling Errors with DPI Use, in Asthma and COPD Patients

Bouros¹,

Evangeliou²

2016

J Pulm Respir Med

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Objective: Correct inhalation technique is crucial for drug delivery to the airways of Asthma and COPD patients. The aim of the current study is to assess the usability of three commonly used DPI devices in Greece in Asthma and COPD patients. Methods:This was a non-interventional, multicenter, observational study that enrolled 755 patients (409 Asthma and 346 COPD). Evaluation of device use was performed at baseline (day 0), immediately after correct use demonstration by the investigator, and final visit (day 30). Assessment was based on 8-step device-specific checklists where all the required inhalation maneuvers were described. Primary variable was the number of critical errors observed during baseline and final visit. The ACQ and CAT questionnaires were used to record patients' perspective about their condition, and the FSI-10 questionnaire to depict patients' feeling of satisfaction from inhaler use.Results: More than 70% of the patients performed all inhalation maneuvers correctly right after the first demonstration by pneumonologist. At final visit approximately 85% of Diskus ® , 93% of Elpenhaler ® , and 75% of Turbuhaler ® users did not make critical errors that affect drug delivery to the lungs. Elpenhaler ® had the lower error rates for critical steps at baseline and final visits (7.0% and 2.5% respectively), whereas the corresponding rates for Diskus ® were 7.3% and 4.9%, and for Turbuhaler ® , 8.5% and 7% respectively. All patients had improved ACQ and CAT scores and were at least fairly satisfied by their inhalers. Conclusions:Demonstration of inhalation technique is of paramount importance, while prescribing an inhaled therapy. Improvement over one-month use was more evident in Elpenhaler ® device. The lower error rates on critical steps for Elpenhaler ® reported at baseline and final visits in combination with the observed improvements in ACQ, CAT and FSI-10 scores suggest better adherence to therapy and disease control.

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Section: Introductionmentioning

confidence: 70%

Critical Steps: A Non-Interventional, Multicenter, Prospective, Observational Study on Critical Handling Errors with DPI Use, in Asthma and COPD Patients

Bouros¹,

Evangeliou²

2016

J Pulm Respir Med

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“…Written information such as medication inserts is not enough, and may convey limited and incomplete information. 38,39 In addition, the acquisition of knowledge alone does not necessarily translate into effective self-management behaviors 40 ; physical demonstration of technique with follow-up assessment and education is essential. 3 Hence, we integrated hands-on education for HCPs into the workshop following the "train the trainer" approach; this is essential for HCPs to develop their own skills, so they can in turn educate patients to insure effective self-management behaviors.…”

Section: Discussionmentioning

confidence: 99%

Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem

et al. 2014

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INTRODUCTION:The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2)

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“…52,53 Although factors such as age, marital status, socioeconomic status, and education level also play a role in patient adherence to aerosol therapy, they do not provide obvious predictors. 19,54,55 On the other hand, depression is an important factor causing nonadherence to prescribed medication and poor disease management in patients with pulmonary disorders such as COPD. [56][57][58] Previous research has shown that adherence to Failing to prime the device, using the device after it is empty, exhaling through the device before inhalation, failing to inhale forcefully pMDIs ϭ pressurized metered-dose inhalers DPIs ϭ dry powder inhalers prescribed medication is an issue especially in low-income and minority subjects.…”

Section: Factors Affecting Patient Adherence To Prescribed Aerosol Thmentioning

confidence: 99%

Patient Education and Adherence to Aerosol Therapy

Ari

2015

Respir Care

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SummaryNonadherence to prescribed medications results in disease instability and poor clinical control, with increases in hospital admissions, emergency room visits, school/work absenteeism, morbidity, and mortality. Poor patient adherence to therapy can be due to lack of cognition, competence, or contrivance. Patients who have not been trained or fail to understand use of drug and device combinations (cognition) often do not have the ability to use an aerosol device correctly (competence). Many patients have the competence to use the device correctly and know why they should RESPIRATORY CARE • JUNE 2015 VOL 60 NO 6 941 use the device in the way they were taught; however, they still contrive to use it in an ineffective and suboptimal manner that reduces its efficiency and effectiveness. Ensuring effective aerosol therapy and optimizing its role in disease management involve not only delivery of aerosolized medications to the lungs, but also understanding why, when, and how to use the medications, competence to use the device, motivation to adhere to therapy, and not contriving to use the device in a way that will prevent effective drug delivery. This paper explains some of the problems with patient education and adherence to aerosol therapy and suggests strategies to evaluate, monitor, and improve patient adherence effectively in primary care. Factors affecting patient adherence to prescribed medications, effective educational interventions, and strategies to promote patient adherence to aerosol therapy are also discussed.

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Patient Perception and Acceptability of Multidose Dry Powder Inhalers: A Randomized Crossover Comparison of Diskus/Accuhaler with Turbuhaler

Cited by 77 publications

References 8 publications

Critical Steps: A Non-Interventional, Multicenter, Prospective, Observational Study on Critical Handling Errors with DPI Use, in Asthma and COPD Patients

Critical Steps: A Non-Interventional, Multicenter, Prospective, Observational Study on Critical Handling Errors with DPI Use, in Asthma and COPD Patients

Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem

Patient Education and Adherence to Aerosol Therapy

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