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Real-life inhaler adherence and technique: Time to get smarter!

Chrystyn H, Audibert R, Keller M, Quaglia B, Vecellio L, Roche N.

Respir Med. 2019 Sep 12;158:24-32. doi: 10.1016/j.rmed.2019.09.008. [Epub ahead of print] Review.


Low-dose oral theophylline combined with inhaled corticosteroids for people with chronic obstructive pulmonary disease and high risk of exacerbations: a RCT.

Devereux G, Cotton S, Fielding S, McMeekin N, Barnes PJ, Briggs A, Burns G, Chaudhuri R, Chrystyn H, Davies L, Soyza A, Gompertz S, Haughney J, Innes K, Kaniewska J, Lee A, Morice A, Norrie J, Sullivan A, Wilson A, Price D.

Health Technol Assess. 2019 Jul;23(37):1-146. doi: 10.3310/hta23370.


Bioavailability of Beclometasone From Two HFA-BDP Formulations With a Spacer.

Said AS, AbuRuz S, Chrystyn H.

Respir Care. 2019 Oct;64(10):1222-1230. doi: 10.4187/respcare.06689. Epub 2019 May 28.


ARIA pharmacy 2018 "Allergic rhinitis care pathways for community pharmacy": AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Santé) POLLAR (Impact of Air POLLution on Asthma and Rhinitis) GARD Demonstration project.

Bosnic-Anticevich S, Costa E, Menditto E, Lourenço O, Novellino E, Bialek S, Briedis V, Buonaiuto R, Chrystyn H, Cvetkovski B, Di Capua S, Kritikos V, Mair A, Orlando V, Paulino E, Salimäki J, Söderlund R, Tan R, Williams DM, Wroczynski P, Agache I, Ansotegui IJ, Anto JM, Bedbrook A, Bachert C, Bewick M, Bindslev-Jensen C, Brozek JL, Canonica GW, Cardona V, Carr W, Casale TB, Chavannes NH, Correia de Sousa J, Cruz AA, Czarlewski W, De Carlo G, Demoly P, Devillier P, Dykewicz MS, Gaga M, El-Gamal Y, Fonseca J, Fokkens WJ, Guzmán MA, Haahtela T, Hellings PW, Illario M, Ivancevich JC, Just J, Kaidashev I, Khaitov M, Khaltaev N, Keil T, Klimek L, Kowalski ML, Kuna P, Kvedariene V, Larenas-Linnemann DE, Laune D, Le LTT, Lodrup Carlsen KC, Mahboub B, Maier D, Malva J, Manning PJ, Morais-Almeida M, Mösges R, Mullol J, Münter L, Murray R, Naclerio R, Namazova-Baranova L, Nekam K, Nyembue TD, Okubo K, O'Hehir RE, Ohta K, Okamoto Y, Onorato GL, Palkonen S, Panzner P, Papadopoulos NG, Park HS, Pawankar R, Pfaar O, Phillips J, Plavec D, Popov TA, Potter PC, Prokopakis EP, Roller-Wirnsberger RE, Rottem M, Ryan D, Samolinski B, Sanchez-Borges M, Schunemann HJ, Sheikh A, Sisul JC, Somekh D, Stellato C, To T, Todo-Bom AM, Tomazic PV, Toppila-Salmi S, Valero A, Valiulis A, Valovirta E, Ventura MT, Wagenmann M, Wallace D, Waserman S, Wickman M, Yiallouros PK, Yorgancioglu A, Yusuf OM, Zar HJ, Zernotti ME, Zhang L, Zidarn M, Zuberbier T, Bousquet J.

Allergy. 2019 Jul;74(7):1219-1236. doi: 10.1111/all.13701. Epub 2019 Apr 30. Review.


Systematic review of association between critical errors in inhalation and health outcomes in asthma and COPD.

Kocks JWH, Chrystyn H, van der Palen J, Thomas M, Yates L, Landis SH, Driessen MT, Gokhale M, Sharma R, Molimard M.

NPJ Prim Care Respir Med. 2018 Nov 16;28(1):43. doi: 10.1038/s41533-018-0110-x.


Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial.

Devereux G, Cotton S, Fielding S, McMeekin N, Barnes PJ, Briggs A, Burns G, Chaudhuri R, Chrystyn H, Davies L, De Soyza A, Gompertz S, Haughney J, Innes K, Kaniewska J, Lee A, Morice A, Norrie J, Sullivan A, Wilson A, Price D.

JAMA. 2018 Oct 16;320(15):1548-1559. doi: 10.1001/jama.2018.14432.


Evaluation of inhaler technique and achievement and maintenance of mastery of budesonide/formoterol Spiromax® compared with budesonide/formoterol Turbuhaler® in adult patients with asthma: the Easy Low Instruction Over Time (ELIOT) study.

Price DB, Thomas V, Richard Dekhuijzen PN, Bosnic-Anticevich S, Roche N, Lavorini F, Raju P, Freeman D, Nicholls C, Small IR, Sims E, Safioti G, Canvin J, Chrystyn H.

BMC Pulm Med. 2018 Jun 28;18(1):107. doi: 10.1186/s12890-018-0665-x.


Relationship of Inhaled Corticosteroid Adherence to Asthma Exacerbations in Patients with Moderate-to-Severe Asthma.

Papi A, Ryan D, Soriano JB, Chrystyn H, Bjermer L, Rodríguez-Roisin R, Dolovich MB, Harris M, Wood L, Batsiou M, Thornhill SI, Price DB.

J Allergy Clin Immunol Pract. 2018 Nov - Dec;6(6):1989-1998.e3. doi: 10.1016/j.jaip.2018.03.008. Epub 2018 Apr 5.


Harmonizing the Nomenclature for Therapeutic Aerosol Particle Size: A Proposal.

Hillyer EV, Price DB, Chrystyn H, Martin RJ, Israel E, van Aalderen WMC, Papi A, Usmani OS, Roche N.

J Aerosol Med Pulm Drug Deliv. 2018 Apr;31(2):111-113. doi: 10.1089/jamp.2017.1396. Epub 2017 Nov 28. No abstract available.


Budesonide + formoterol delivered via Spiromax® for the management of asthma and COPD: The potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler®.

Lewis A, Torvinen S, Dekhuijzen PNR, Chrystyn H, Melani A, Zöllner Y, Kolbe K, Watson AT, Blackney M, Plich A.

Respir Med. 2017 Aug;129:179-188. doi: 10.1016/j.rmed.2017.06.018. Epub 2017 Jun 27.


Study of the Emitted Dose After Two Separate Inhalations at Different Inhalation Flow Rates and Volumes and an Assessment of Aerodynamic Characteristics of Indacaterol Onbrez Breezhaler® 150 and 300 μg.

Abadelah M, Chrystyn H, Bagherisadeghi G, Abdalla G, Larhrib H.

AAPS PharmSciTech. 2018 Jan;19(1):251-261. doi: 10.1208/s12249-017-0841-y. Epub 2017 Jul 10.


Device errors in asthma and COPD: systematic literature review and meta-analysis.

Chrystyn H, van der Palen J, Sharma R, Barnes N, Delafont B, Mahajan A, Thomas M.

NPJ Prim Care Respir Med. 2017 Apr 3;27(1):22. doi: 10.1038/s41533-017-0016-z. Review.


Effect of maximum inhalation flow and inhaled volume on formoterol drug deposition in-vitro from an Easyhaler® dry powder inhaler.

Abadelah M, Hazim F, Chrystyn H, Bagherisadeghi G, Rahmoune H, Larhrib H.

Eur J Pharm Sci. 2017 Jun 15;104:180-187. doi: 10.1016/j.ejps.2017.03.035. Epub 2017 Mar 27.


A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices.

van der Palen J, Thomas M, Chrystyn H, Sharma RK, van der Valk PD, Goosens M, Wilkinson T, Stonham C, Chauhan AJ, Imber V, Zhu CQ, Svedsater H, Barnes NC.

NPJ Prim Care Respir Med. 2017 Mar 23;27:17001. doi: 10.1038/npjpcrm.2017.1. No abstract available.


Inhaler technique mastery and maintenance in healthcare professionals trained on different devices.

Bosnic-Anticevich S, Callan C, Chrystyn H, Lavorini F, Nikolaou V, Kritikos V, Dekhuijzen PNR, Roche N, Bjermer L, Rand C, Zwar N, Price DB.

J Asthma. 2018 Jan;55(1):79-88. doi: 10.1080/02770903.2017.1310227. Epub 2017 Apr 28.


Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes.

Price DB, Román-Rodríguez M, McQueen RB, Bosnic-Anticevich S, Carter V, Gruffydd-Jones K, Haughney J, Henrichsen S, Hutton C, Infantino A, Lavorini F, Law LM, Lisspers K, Papi A, Ryan D, Ställberg B, van der Molen T, Chrystyn H.

J Allergy Clin Immunol Pract. 2017 Jul - Aug;5(4):1071-1081.e9. doi: 10.1016/j.jaip.2017.01.004. Epub 2017 Mar 9.


Real life dose emission characterization using COPD patient inhalation profiles when they inhaled using a fixed dose combination (FDC) of the medium strength Symbicort® Turbuhaler®.

Bagherisadeghi G, Larhrib EH, Chrystyn H.

Int J Pharm. 2017 Apr 30;522(1-2):137-146. doi: 10.1016/j.ijpharm.2017.02.057. Epub 2017 Feb 28.


The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes.

Bosnic-Anticevich S, Chrystyn H, Costello RW, Dolovich MB, Fletcher MJ, Lavorini F, Rodríguez-Roisin R, Ryan D, Wan Yau Ming S, Price DB.

Int J Chron Obstruct Pulmon Dis. 2016 Dec 21;12:59-71. doi: 10.2147/COPD.S117196. eCollection 2017. Erratum in: Int J Chron Obstruct Pulmon Dis. 2019 Aug 02;14:1739.


A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices.

van der Palen J, Thomas M, Chrystyn H, Sharma RK, van der Valk PD, Goosens M, Wilkinson T, Stonham C, Chauhan AJ, Imber V, Zhu CQ, Svedsater H, Barnes NC.

NPJ Prim Care Respir Med. 2016 Nov 24;26:16079. doi: 10.1038/npjpcrm.2016.79. Erratum in: NPJ Prim Care Respir Med. 2017 Mar 23;27:17001.


Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device.

Dekhuijzen PNR, Batsiou M, Bjermer L, Bosnic-Anticevich S, Chrystyn H, Papi A, Rodríguez-Roisin R, Fletcher M, Wood L, Cifra A, Soriano JB, Price DB.

Respir Med. 2016 Nov;120:54-63. doi: 10.1016/j.rmed.2016.09.015. Epub 2016 Sep 22.


"Trying, But Failing" - The Role of Inhaler Technique and Mode of Delivery in Respiratory Medication Adherence.

Braido F, Chrystyn H, Baiardini I, Bosnic-Anticevich S, van der Molen T, Dandurand RJ, Chisholm A, Carter V, Price D; Respiratory Effectiveness Group.

J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):823-32. doi: 10.1016/j.jaip.2016.03.002. Review.


In vitro aerodynamic characteristics of aerosol delivered from different inhalation methods in mechanical ventilation.

ElHansy MHE, Boules ME, Farid H, Chrystyn H, El-Maraghi SK, Al-Kholy MB, El-Essawy AFM, Abdelrahman MM, Said ASA, Hussein RRS, Rabea H, Abdelrahim MEA.

Pharm Dev Technol. 2017 Sep;22(6):844-849. doi: 10.1080/10837450.2016.1221427. Epub 2016 Aug 30.


The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries.

Lewis A, Torvinen S, Dekhuijzen PN, Chrystyn H, Watson AT, Blackney M, Plich A.

BMC Health Serv Res. 2016 Jul 12;16:251. doi: 10.1186/s12913-016-1482-7.


MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis.

Bousquet J, Schünemann HJ, Hellings PW, Arnavielhe S, Bachert C, Bedbrook A, Bergmann KC, Bosnic-Anticevich S, Brozek J, Calderon M, Canonica GW, Casale TB, Chavannes NH, Cox L, Chrystyn H, Cruz AA, Dahl R, De Carlo G, Demoly P, Devillier P, Dray G, Fletcher M, Fokkens WJ, Fonseca J, Gonzalez-Diaz SN, Grouse L, Keil T, Kuna P, Larenas-Linnemann D, Lodrup Carlsen KC, Meltzer EO, Mullol J, Muraro A, Naclerio RN, Palkonen S, Papadopoulos NG, Passalacqua G, Price D, Ryan D, Samolinski B, Scadding GK, Sheikh A, Spertini F, Valiulis A, Valovirta E, Walker S, Wickman M, Yorgancioglu A, Haahtela T, Zuberbier T; MASK study group*.

J Allergy Clin Immunol. 2016 Aug;138(2):367-374.e2. doi: 10.1016/j.jaci.2016.03.025. Epub 2016 Apr 23. Review.


An Open-Label Investigation of the Pharmacokinetics and Tolerability of Oral Cysteamine in Adults with Cystic Fibrosis.

Devereux G, Steele S, Griffiths K, Devlin E, Fraser-Pitt D, Cotton S, Norrie J, Chrystyn H, O'Neil D.

Clin Drug Investig. 2016 Aug;36(8):605-12. doi: 10.1007/s40261-016-0405-z.


Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting.

Westerik JA, Carter V, Chrystyn H, Burden A, Thompson SL, Ryan D, Gruffydd-Jones K, Haughney J, Roche N, Lavorini F, Papi A, Infantino A, Roman-Rodriguez M, Bosnic-Anticevich S, Lisspers K, Ställberg B, Henrichsen SH, van der Molen T, Hutton C, Price DB.

J Asthma. 2016;53(3):321-9. doi: 10.3109/02770903.2015.1099160. Epub 2016 Jan 26.


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

Chrystyn H, Price DB, Molimard M, Haughney J, Bosnic-Anticevich S, Lavorini F, Efthimiou J, Shan D, Sims E, Burden A, Hutton C, Roche N.

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


In vitro aerodynamic characterization of the dose emitted during nebulization of tobramycin high strength solution by novel and jet nebulizer delivery systems.

Mashat M, Clark BJ, Assi KH, Chrystyn H.

Pulm Pharmacol Ther. 2016 Apr;37:37-42. doi: 10.1016/j.pupt.2015.12.003. Epub 2015 Dec 30.


Concept review of dry powder inhalers: correct interpretation of published data.

Price D, Chrystyn H.

Multidiscip Respir Med. 2015 Dec 2;10:36. doi: 10.1186/s40248-015-0033-0. eCollection 2015.


Spiromax, a New Dry Powder Inhaler: Dose Consistency under Simulated Real-World Conditions.

Canonica GW, Arp J, Keegstra JR, Chrystyn H.

J Aerosol Med Pulm Drug Deliv. 2015 Oct;28(5):309-19. doi: 10.1089/jamp.2015.1216. Epub 2015 Sep 9.


Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

Devereux G, Cotton S, Barnes P, Briggs A, Burns G, Chaudhuri R, Chrystyn H, Davies L, De Soyza A, Fielding S, Gompertz S, Haughney J, Lee AJ, McCormack K, McPherson G, Morice A, Norrie J, Sullivan A, Wilson A, Price D.

Trials. 2015 Jun 10;16:267. doi: 10.1186/s13063-015-0782-2.


Effect of inhalation profile and throat geometry on predicted lung deposition of budesonide and formoterol (BF) in COPD: An in-vitro comparison of Spiromax with Turbuhaler.

Chrystyn H, Safioti G, Keegstra JR, Gopalan G.

Int J Pharm. 2015 Aug 1;491(1-2):268-76. doi: 10.1016/j.ijpharm.2015.05.076. Epub 2015 Jun 1.


Inhalation characteristics of asthma patients, COPD patients and healthy volunteers with the Spiromax® and Turbuhaler® devices: a randomised, cross-over study.

Azouz W, Chetcuti P, Hosker H, Saralaya D, Chrystyn H.

BMC Pulm Med. 2015 May 1;15:47. doi: 10.1186/s12890-015-0043-x.


Preference, satisfaction and critical errors with Genuair and Breezhaler inhalers in patients with COPD: a randomised, cross-over, multicentre study.

Pascual S, Feimer J, De Soyza A, Sauleda Roig J, Haughney J, Padullés L, Seoane B, Rekeda L, Ribera A, Chrystyn H.

NPJ Prim Care Respir Med. 2015 Apr 30;25:15018. doi: 10.1038/npjpcrm.2015.18.


Indacaterol determination in human urine: validation of a liquid-liquid extraction and liquid chromatography-tandem mass spectrometry analytical method.

Ammari WG, Al-Qadhi Z, Khalil M, Tayyem R, Qammaz S, Oriquat G, Basheti IA, Chrystyn H.

J Aerosol Med Pulm Drug Deliv. 2015 Jun;28(3):202-10. doi: 10.1089/jamp.2014.1153. Epub 2014 Sep 17.


Evaluation of asthma control, parents' quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma.

Ammari WG, Toor S, Chetcuti P, Stephenson J, Chrystyn H.

J Asthma. 2015 Apr;52(3):301-7. doi: 10.3109/02770903.2014.966111. Epub 2014 Oct 8.


NEXThaler, an innovative dry powder inhaler delivering an extrafine fixed combination of beclometasone and formoterol to treat large and small airways in asthma.

Corradi M, Chrystyn H, Cosio BG, Pirozynski M, Loukides S, Louis R, Spinola M, Usmani OS.

Expert Opin Drug Deliv. 2014 Sep;11(9):1497-506. doi: 10.1517/17425247.2014.928282. Epub 2014 Jun 12. Review. Erratum in: Expert Opin Drug Deliv. 2014 Nov;11(11):1827.


The inhalation characteristics of patients when they use different dry powder inhalers.

Azouz W, Chetcuti P, Hosker HS, Saralaya D, Stephenson J, Chrystyn H.

J Aerosol Med Pulm Drug Deliv. 2015 Feb;28(1):35-42. doi: 10.1089/jamp.2013.1119. Epub 2014 May 9.


Impact of patients' satisfaction with their inhalers on treatment compliance and health status in COPD.

Chrystyn H, Small M, Milligan G, Higgins V, Gil EG, Estruch J.

Respir Med. 2014 Feb;108(2):358-65. doi: 10.1016/j.rmed.2013.09.021. Epub 2013 Oct 2.


Aerodynamic dose emission characteristics of dry powder inhalers using an Andersen Cascade Impactor with a mixing inlet: the influence of flow and volume.

Yakubu SI, Assi KH, Chrystyn H.

Int J Pharm. 2013 Oct 15;455(1-2):213-8. doi: 10.1016/j.ijpharm.2013.07.036. Epub 2013 Jul 24.


Improved metered dose inhaler technique when a coordination cap is used.

Azouz W, Campbell J, Stephenson J, Saralaya D, Chrystyn H.

J Aerosol Med Pulm Drug Deliv. 2014 Jun;27(3):193-9. doi: 10.1089/jamp.2012.1031. Epub 2013 Jul 9.


Optimizing the inhalation flow and technique through metered dose inhalers of asthmatic adults and children attending a community pharmacy.

Ammari WG, Chrystyn H.

J Asthma. 2013 Jun;50(5):505-13. doi: 10.3109/02770903.2013.783064. Epub 2013 Apr 15.


Inhaler competence in asthma: common errors, barriers to use and recommended solutions.

Inhaler Error Steering Committee, Price D, Bosnic-Anticevich S, Briggs A, Chrystyn H, Rand C, Scheuch G, Bousquet J.

Respir Med. 2013 Jan;107(1):37-46. doi: 10.1016/j.rmed.2012.09.017. Epub 2012 Oct 23. Review.


Droplet aerodynamics, cellular uptake, and efficacy of a nebulizable corticosteroid nanosuspension are superior to a micronized dosage form.

Britland S, Finter W, Chrystyn H, Eagland D, Abdelrahim ME.

Biotechnol Prog. 2012 Sep-Oct;28(5):1152-9. doi: 10.1002/btpr.1616. Epub 2012 Sep 21.


Effectiveness of same versus mixed asthma inhaler devices: a retrospective observational study in primary care.

Price D, Chrystyn H, Kaplan A, Haughney J, Román-Rodríguez M, Burden A, Chisholm A, Hillyer EV, von Ziegenweidt J, Ali M, van der Molen T.

Allergy Asthma Immunol Res. 2012 Jul;4(4):184-91. doi: 10.4168/aair.2012.4.4.184. Epub 2012 Apr 6.


The Genuair® inhaler: a novel, multidose dry powder inhaler.

Chrystyn H, Niederlaender C.

Int J Clin Pract. 2012 Mar;66(3):309-17. doi: 10.1111/j.1742-1241.2011.02832.x. Review.


Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice.

Azouz W, Chrystyn H.

Prim Care Respir J. 2012 Jun;21(2):208-13. doi: 10.4104/pcrj.2012.00010. Review.


Urinary pharmacokinetic methodology to determine the relative lung bioavailability of inhaled beclometasone dipropionate.

Said AS, Harding LP, Chrystyn H.

Br J Clin Pharmacol. 2012 Sep;74(3):456-64. doi: 10.1111/j.1365-2125.2012.04210.x.

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