Recommendations for the Choice of Inhalatory Systems for Drug Prescription

Voshaar, T; App, Ernst M.; Berdel, Dietrich; Buhl, Roland; Fischer, Jörg; Gessler, Tobias; Haidl, P.; Heyder, Joachin; Kohler, David R.; Kohlhäufl, med. Martin; Lehr, Claus‐Michael; Lindemann, H.; Matthys, H; Meyer, Tricia A.; Olschewski, Horst; Paul, K. D.; Rabe, Klaus F.; Raschke, F.; Scheuch, G.; Schmehl, Thomas; Schultze‐Werninghaus, G.; Ukena, D.; Worth, H.

doi:10.1055/s-2001-19003

Cited by 36 publications

(10 citation statements)

References 53 publications

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“…Different inhaler devices can be demonstrated and the person with asthma encouraged to participate in the decision as to which is most suitable for them. Criteria for the initial selection of inhaler device include device availability and cost, patient skills, and preferences of the health professional and patient [142,223,224]. Patients should be given adequate opportunity to express their expectations of both their asthma and its treatment.…”

Section: Asthma Educationmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2007

Eur Respir J

2,664

2,301

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Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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Section: Asthma Educationmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2007

Eur Respir J

2,664

2,301

View full text Add to dashboard Cite

show abstract

“…Voshaar et al have proposed that the use of inspiratory flow measurements and the ability to coordinate actuation and inhalation of inhalers may provide guidance to the most appropriate inhaler for individual patients (TaBle 2) [53]. This guide suggests that patients who naturally have a tendency to have a fast inhalation would be better suited to DPIs, whereas those with a slower inhalation speed would be best suited to a pMDI.…”

Section: Choosing the Correct Inhalermentioning

confidence: 99%

Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma

Capstick

Clifton²

2012

Expert Review of Respiratory Medicine

119

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“…the use of a device algorithm. Two examples of algorithms suggested by VOSHAAR et al [36] and VIRCHOW et al [37] start from a different reference point to the primary care consultation, and are applicable to patients in any setting, including the hospital. However, both include elements that could be incorporated into a primary care algorithm, namely that some assessment needs to be made of how well patients can inspire, how well they can coordinate device actuation with inspiration and recommendations on the environmental impact of devices.…”

Section: Possible Approaches To Inhaler Selectionmentioning

confidence: 99%

“…ozone depletion), only CFC-free devices should be used. Table 3, adapted from the algorithm published by VOSHAAR et al [36], categorises the suitability of device types discussed earlier in this article according to inspiratory flow and coordination skill. Although the use of a spacer and valve with a pMDI can help patients who are poor at coordination, a large proportion of patients who are advised to use spacers fail to do so, because the devices are cumbersome and because patients are uncertain about practical issues such as cleaning or whether the spacer needs to be carried with them (which is impractical for most).…”

Section: Possible Approaches To Inhaler Selectionmentioning

confidence: 99%

Inhaler choice in primary practice

Chapman¹,

Voshaar²,

Jc³

2005

Eur Respir Rev

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A broad range of inhaler devices is available for physicians to prescribe. Although newer devices are often easier to use than conventional pressurised metered-dose inhalers (pMDIs), many patients still use inhalers sub-optimally. Physicians must become familiar with the characteristics of several inhalers and choose the device that their patients can use correctly and beneficially if they are to prescribe successfully to those with chronic obstructive pulmonary disease (COPD). The selection of a device may also be influenced by patient comorbidities and by their ability to handle and inhale correctly from the device. A further challenge in the COPD setting is measuring the desired treatment outcome.A simple algorithm or checklist can guide device selection in primary care. The device must be affordable for the patient, the patient must be able to handle it correctly and the practitioner or other trained professional should monitor that it is being used correctly. The patient's and physician's preferences should also be taken into account. The most important device-handling skills that should be assessed are whether the patient can: properly prepare and actuate the device; take an adequate inspiration; and coordinate actuation of a pMDI with inspiration.Testing the practicality and advantages of such checklists will mean better use can be made of the inhaler types currently available as well as newer designs. In the interim, caregiver and patient education are needed.

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Recommendations for the Choice of Inhalatory Systems for Drug Prescription

Cited by 36 publications

References 53 publications

Global strategy for asthma management and prevention: GINA executive summary

Global strategy for asthma management and prevention: GINA executive summary

Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma

Inhaler choice in primary practice

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