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BMC Pulm Med. 2016 Jan 14;16:12. doi: 10.1186/s12890-016-0169-5.

Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study.

Author information

1
Inhalation Consultancy Ltd, Yeadon, Leeds, West Yorkshire, UK.
2
Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK.
3
Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK. dprice@rirl.org.
4
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. dprice@rirl.org.
5
Department of Medical Pharmacology, CHU et Univ. de Bordeaux, Bordeaux, France.
6
Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
7
Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney and Sydney Local Health District, Sydney, Australia.
8
Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy.
9
Horizon Respiratory Consultancy, Oxford, UK.
10
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
11
University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris, France.

Abstract

BACKGROUND:

Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers.

METHODS:

Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder.

RESULTS:

Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (n = 277) and Pulmojet-Turbohaler (n = 144) comparisons. Non-inferiority in the proportions of patients recording no nurse-observed serious errors was demonstrated for both Pulmojet versus Diskus, and Pulmojet versus Turbohaler; therefore, superiority was tested. Patients were significantly less likely to make ≥1 nurse-observed serious errors using Pulmojet compared with Diskus (odds ratio, 0.31; 95 % CI, 0.19-0.51) or Pulmojet compared with Turbohaler (0.23; 0.12-0.44) after reading the patient information leaflet with additional video instruction, if required.

CONCLUSIONS:

These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT01794390 (February 14, 2013).

PMID:
26769482
PMCID:
PMC4712500
DOI:
10.1186/s12890-016-0169-5
[Indexed for MEDLINE]
Free PMC Article

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