For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
1
views
9
references
 Top references
cited by
0
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      119
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Effect of Unintentional Storage and Handling Errors of Inhaled Medications: What Does This Mean for Therapeutic Equivalence Considerations?

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Currently, the equivalence and the substitutability of two inhaled medications are mainly driven by comparability of doses, in vitro performance, therapeutic equivalence and sameness, and handling of the inhalers. The packaging configuration is usually not considered as a factor.

          Methods: Two capsule-based inhaled tiotropium-containing products that differ by their primary packaging configurations (blister versus bottle) were compared in terms of potential handling and resulting storage errors due to unintentional misuse. Use error scenarios were identified and investigated for both the blister-packaged tiotropium and the bottled tiotropium capsules. The impact of the air exposure resulting from the packaging interaction errors was evaluated in vitro using fine particle dose (FPD) and delivered dose.

          Results: Numbers of potential errors and criticality in terms of the potential effect impact on the FPD were larger for the bottled product (between 40% and 90% loss on FPD related to initial dose). The loss of FPD could significantly impact the amount of medication that can actually reach the patient's lungs.

          Conclusion: When considering prescribing an inhaled medication, the specifics of the packaging and the patient's abilities and situation shall be taken into account to minimize possible handling and subsequent dosing errors.

          Related collections

          Most cited references9

          • Record: found
          • Abstract: found
          • Article: not found

          Objective Assessment of Adherence to Inhalers by Patients with Chronic Obstructive Pulmonary Disease.

          Imran Sulaiman, Breda Cushen, Garrett Greene … (2017)
          Objective adherence to inhaled therapy by patients with chronic obstructive pulmonary disease (COPD) has not been reported.
          Article 0 comments Cited 70 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A review of national guidelines for management of COPD in Europe

            Marc Miravitlles, Claus Vogelmeier, Nicolas Roche … (2016)
            The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them. This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g. theophylline and mucolytics) in addition to bronchodilators. There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments.
            Article 0 comments Cited 62 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method.

              Agnes J O Jong, Eugene Jansen, Geert Rootmensen … (2010)
              Inadequate technique reduces the effects of inhalation medication. Errors in inhalation technique have been reported to range up to 85%. Not only various patients' characteristics but also the device has an effect on correct inhalation technique. The purpose of this study was to determine the effect of patients' characteristics and type of inhaler device on inhalation technique in patient with asthma or chronic obstructive pulmonary disease (COPD). A validated scoring method was used that consisted of triple viewing of video-recorded inhalations, using device-specific checklists. The following patient characteristics were investigated: gender, age, education level, diagnosis, treatment by a pulmonary physician, previously received inhalation instruction, exacerbation frequency, knowledge, self-management competence, pulmonary function, and use of multiple inhaler devices. Chi-square statistics were used for univariate associations between potential determinants and correctness of inhalation technique. Relevant determinants were entered into a multivariate logistic regression model. Moreover, inhalation technique errors were examined for six inhaler devices: three prefilled dry powder inhalers, one single-dose dry powder inhaler, a pressurized metered-dose inhaler (pMDI) and a pMDI with a spacer. Overall, 40% of the patients made at least one essential mistake in their inhalation technique. Patients who never received inhalation instruction and patients who used more than one inhaler device made significantly more errors (odds ratio both 2.2). Comparison between devices showed that a correct inhalation technique most likely occurred with the use of prefilled dry powder devices. Incorrect inhalation technique is common among asthma and COPD patients in a pulmonary outpatient clinic. Our study suggests that the use of prefilled dry powder inhalers as well as inhalation instruction increases correct inhalation technique. Simultaneous use of different types of inhalation devices has to be discouraged.
              Article 0 comments Cited 57 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): J Aerosol Med Pulm Drug Deliv
                Journal ID (iso-abbrev): J Aerosol Med Pulm Drug Deliv
                Journal ID (publisher-id): jamp
                Title: Journal of Aerosol Medicine and Pulmonary Drug Delivery
                Publisher: Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                ISSN (Print): 1941-2711
                ISSN (Electronic): 1941-2703
                Publication date (Print): 01 June 2019
                Publication date (Electronic): 24 May 2019
                Publication date PMC-release: 24 May 2019
                Volume: 32
                Issue: 3
                Pages: 121-131
                Affiliations
                [1]Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany.
                Author notes
                [*]Address correspondence to: Markus Wolkenhauer, Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Strasse 173, 55216 Ingelheim am Rhein, Germany markus.wolkenhauer@ 123456boehringer-ingelheim.com
                Article
                Publisher ID: 10.1089/jamp.2018.1480
                DOI: 10.1089/jamp.2018.1480
                PMC ID: 6622574
                PubMed ID: 30523717
                SO-VID: b2c2a7db-88fb-4afd-b7da-391340618948
                Copyright © © Markus Wolkenhauer, et al., 2018. Published by Mary Ann Liebert, Inc.
                License:

                This Open Access article is distributed under the terms of the Creative Commons License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the orginal work is properly credited.

                History
                Date received : 13 June 2018
                Date accepted : 12 October 2018
                Page count
                Figures: 12, Tables: 3, References: 23, Pages: 11
                Categories
                Subject: Original Research

                Keywords: handling,inhaled therapy,packaging,unintentional misuse
                Data availability:
                Keywords: handling, inhaled therapy, packaging, unintentional misuse

                Comments

                Comment on this article