Department of Pneumonology, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.
BMC Pulm Med. 2020 Aug 20;20(1):222. doi: 10.1186/s12890-020-01246-z.
Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors.
Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer.
Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p = 0.002) and COPD vs. asthma patients (p = 0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance.
Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.
吸入疗法是哮喘和 COPD 控制的基础。然而，在现实生活中，吸入器的使用和设备处理不当仍然是一个问题。一些研究表明，使用患者首选的吸入器可以减少设备处理错误，并提高对规定的慢性吸入器药物治疗的依从性。本研究旨在比较德国慢性阻塞性呼吸道疾病患者对常用吸入器设备的偏好。我们还探讨了哪些吸入器设备的特性对用户特别重要，以及年龄、性别和疾病类型（哮喘或 COPD）对设备偏好和处理错误可能产生的影响。
这是一项前瞻性、开放性、横断面研究，共纳入 105 例哮喘（58%）或 COPD（42%）患者。使用经过验证的清单客观评估 10 种不同安慰剂设备的吸入技术和错误。对于每种设备，患者都需要测试操作、评估设备特性并选择他们最不喜欢或最喜欢的设备。
在测试的 10 种安慰剂吸入器设备中，患者平均需要尝试 1.22 次才能实现无错误使用。尝试次数最少的设备是 Turbohaler®（1.02），其次是 Nexthaler®（1.04）、Diskus®（1.07）和 Spiromax®（1.10）。60 岁以上的患者比年轻患者（p=0.002）和 COPD 患者比哮喘患者（p=0.016）需要更多的尝试才能确保正确使用。41%的研究参与者选择了他们已经使用过的设备之一作为最喜爱的吸入器。总体而言，20%的人选择 Spiromax®，15%的人选择 Nexthaler®，14%的人选择 Turbohaler®或 pMDI。最不喜欢的设备是 Elpenhaler®（0%）。在从 7 个预定义的吸入器属性中选择的情况下，患者表示易于操作对他们最重要。其次是短吸入时间和低吸入阻力。
患者对吸入器设备的偏好可能有所不同。Turbohaler®和 Nexthaler®报告的无错误使用尝试次数最少。Spiromax®和 Nexthaler®获得了最佳的总体评分，是患者最喜爱的设备。
