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      Inhaler Competence and Patient Satisfaction with Easyhaler ®: Results of Two Real-Life Multicentre Studies in Asthma and COPD

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          Abstract

          Objective

          The aim of this study was to investigate patients’ inhaler competence and satisfaction with the Easyhaler ® dry powder inhaler.

          Design

          Two open, uncontrolled, non-randomised studies.

          Setting

          Real life based on patients attending 56 respiratory clinics in Hungary.

          Participants

          Patients with asthma or chronic obstructive pulmonary disease (COPD) ( n = 1016).

          Intervention

          In a 3-month study, adult patients (age range 18–88 years; n = 797) received twice-daily inhalations of formoterol via Easyhaler ®, and in a consequential study (from one visit to another, with 3–12 months in-between) children and adolescents (age range 4–17 years; n = 219) received salbutamol via Easyhaler ® as needed.

          Main Outcome Measures

          Control of six Easyhaler ® handling steps and patients’ satisfaction with Easyhaler ® based on questionnaires.

          Results

          Correct performances (minimum and maximum of the six steps) were noticed after one demonstration in 92–98 % of the adults, 87–99 % of the elderly, 81–96 % of the children and 83–99 % of the adolescents. These figures had markedly increased at the last visit. Repeat instructions were necessary in 26 % of the cases. Investigators found Easyhaler ® easy to teach in 87 % of the patients and difficult in only 0.5 %. Patients found Easyhaler ® easy to learn and use, and the patients’ (and parents’) satisfaction with the inhaler was very high. Lung function values [forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC), peak expiratory flow (PEF)] improved statistically significantly during the studies, indicating good inhaler competence and treatment adherence.

          Conclusion

          Investigators found Easyhaler ® easy to teach and patients found it easy to use, and their satisfaction with the device was high.

          Related collections

          Most cited references32

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          What the pulmonary specialist should know about the new inhalation therapies.

          A collaboration of multidisciplinary experts on the delivery of pharmaceutical aerosols was facilitated by the European Respiratory Society (ERS) and the International Society for Aerosols in Medicine (ISAM), in order to draw up a consensus statement with clear, up-to-date recommendations that enable the pulmonary physician to choose the type of aerosol delivery device that is most suitable for their patient. The focus of the consensus statement is the patient-use aspect of the aerosol delivery devices that are currently available. The subject was divided into different topics, which were in turn assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. To achieve consensus, draft reports and recommendations were reviewed and voted on by the entire panel. Specific recommendations for use of the devices can be found throughout the statement. Healthcare providers should ensure that their patients can and will use these devices correctly. This requires that the clinician: is aware of the devices that are currently available to deliver the prescribed drugs; knows the various techniques that are appropriate for each device; is able to evaluate the patient's inhalation technique to be sure they are using the devices properly; and ensures that the inhalation method is appropriate for each patient.
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            Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD.

            Incorrect usage of inhaler devices might have a major influence on the clinical effectiveness of the delivered drug. This issue is poorly addressed in management guidelines. This article presents the results of a systematic literature review of studies evaluating incorrect use of established dry powder inhalers (DPIs) by patients with asthma or chronic obstructive pulmonary disease (COPD). Overall, we found that between 4% and 94% of patients, depending on the type of inhaler and method of assessment, do not use their inhalers correctly. The most common errors made included failure to exhale before actuation, failure to breath-hold after inhalation, incorrect positioning of the inhaler, incorrect rotation sequence, and failure to execute a forceful and deep inhalation. Inefficient DPI technique may lead to insufficient drug delivery and hence to insufficient lung deposition. As many as 25% of patients have never received verbal inhaler technique instruction, and for those that do, the quality and duration of instruction is not adequate and not reinforced by follow-up checks. This review demonstrates that incorrect DPI technique with established DPIs is common among patients with asthma and COPD, and suggests that poor inhalation technique has detrimental consequences for clinical efficacy. Regular assessment and reinforcement of correct inhalation technique are considered by health professionals and caregivers to be an essential component of successful asthma management. Improvement of asthma and COPD management could be achieved by new DPIs that are easy to use correctly and are forgiving of poor inhalation technique, thus ensuring more successful drug delivery.
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              • Record: found
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              Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study.

              Asthma management guidelines provide recommendations for the optimum control of asthma. This survey assessed the current levels of asthma control as reported by patients, which partly reflect the extent to which guideline recommendations are implemented. Current asthma patients were identified by telephone by screening 73,880 households in seven European countries. Designated respondents were interviewed on healthcare utilization, symptom severity, activity limitations and asthma control. Current asthma patients were identified in 3,488 households, and 2,803 patients (80.4%) completed the survey. Forty-six per cent of patients reported daytime symptoms and 30% reported asthma-related sleep disturbances, at least once a week. In the past 12 months, 25% of patients reported an unscheduled urgent care visit, 10% reported one or more emergency room visits and 7% reported overnight hospitalization due to asthma. In the past 4 weeks, more patients had used prescription quick-relief medication (63%) than inhaled corticosteroids (23%). Patient perception of asthma control did not match their symptom severity; approximately 50% of patients reporting severe persistent symptoms also considered their asthma to be completely or well controlled. The current level of asthma control in Europe falls far short of the goals for long-term asthma management. Patients' perception of asthma control is different from their actual asthma control.
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                Author and article information

                Contributors
                +46-702-256757 , olof.selroos@telia.com
                Journal
                Drugs R D
                Drugs R D
                Drugs in R&d
                Springer International Publishing (Cham )
                1174-5886
                1179-6901
                17 September 2013
                17 September 2013
                2013
                : 13
                : 215-222
                Affiliations
                [ ]Department of Pulmonology, Semmelweis University Faculty of Medicine, Budapest, Hungary
                [ ]1st Department of Paediatrics, Semmelweis University Faculty of Medicine, Budapest, Hungary
                [ ]4th Department of Paediatrics, Hospital of BAZ County, Miskolc, Hungary
                [ ]Selroos Medical Consulting AB, Skogsvägen 5, 266 54 Vejbystrand, Sweden
                Article
                27
                10.1007/s40268-013-0027-3
                3784057
                24043456
                1fa04067-b8d3-44b2-afe4-93479ee2d8f1
                © The Author(s) 2013

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

                History
                Categories
                Original Research Article
                Custom metadata
                © Springer International Publishing Switzerland 2013

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