Vall'd Hebrón Hospital, Department of Pneumology, Barcelona, Spain.
Santa Creu i Sant Pau Hospital, Department of Asthma and Allergy Unit, Barcelona, Spain.
Respir Care. 2024 Nov 18;69(12):1534-1542. doi: 10.4187/respcare.11643.
This study aimed to describe the use of pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) in Spanish subjects in terms of sociodemographic, clinical, and functional characteristics in subjects with asthma or COPD on maintenance treatment with inhaled therapy.
This was a retrospective, descriptive, national, multi-center, and observational study using a database with 1.8 million patients from hospitals and primary care centers as a secondary information source.
The sample included 24,102 subjects with asthma on maintenance therapy (26.0% with pMDI, 55% with DPI, and 19.0% with a combination of DPI + pMDI inhalers) and 12,858 subjects with COPD on maintenance therapy (26% with pMDI; 39% with DPI; and 35% with a combination of pMDI + DPI inhalers, mostly extemporary triple therapy). In proportion, subjects ≥ 75 y old used more pMDI than DPI, while younger subjects (40-64 y old) used more DPI. An inhalation chamber was prescribed in 51.0% of subjects with asthma and 47.2% of subjects with COPD treated with pMDI. The use of an inhalation chamber increases with the degree of air-flow limitation by disease and age. In subjects with comorbidities, pMDI inhaler use increased in those ≥ 75 y old for subjects with asthma and subjects with COPD. Switching from pMDI to DPI and vice versa was relatively common: 25% of subjects with asthma and 21.6% of subjects with COPD treated with pMDI had switched from DPI in the previous year. On the contrary, 14.1% and 11.4% of subjects with asthma and subjects with COPD, respectively, treated with DPI had switched from pMDI the last year.
The use of pMDI or DPI can vary according to age, both in asthma and COPD. Switching from pMDI to DPI and vice versa is relatively common. Despite the availability of dual- and triple-therapy inhalers on the market, a considerable number of subjects were treated with multiple devices.
本研究旨在描述在接受吸入疗法维持治疗的哮喘或 COPD 患者中，根据社会人口统计学、临床和功能特征，使用压力定量气雾剂（pMDI）和干粉吸入器（DPI）的情况。
这是一项回顾性、描述性、全国性、多中心、观察性研究，使用了来自医院和初级保健中心的 180 万患者数据库作为二级信息来源。
样本包括 24102 名接受维持治疗的哮喘患者（26.0%使用 pMDI，55%使用 DPI，19.0%使用 DPI+pMDI 联合吸入器）和 12858 名接受维持治疗的 COPD 患者（26%使用 pMDI；39%使用 DPI；35%使用 pMDI+DPI 联合吸入器，主要是临时三联疗法）。比例上，≥75 岁的患者使用 pMDI 多于 DPI，而较年轻的患者（40-64 岁）使用 DPI 多于 pMDI。在接受 pMDI 治疗的哮喘患者中，有 51.0%和 COPD 患者中，有 47.2%被处方了吸入室。使用吸入室的比例随着疾病和年龄导致的气流受限程度的增加而增加。在合并症患者中，≥75 岁的哮喘患者和 COPD 患者使用 pMDI 吸入器的比例增加。从 pMDI 切换到 DPI 和反之亦然的情况相对常见：在过去一年中，25%接受 pMDI 治疗的哮喘患者和 21.6%接受 pMDI 治疗的 COPD 患者已从 DPI 切换。相反，在过去一年中，分别有 14.1%和 11.4%接受 DPI 治疗的哮喘患者和 COPD 患者已从 pMDI 切换。
pMDI 或 DPI 的使用可能因年龄而异，在哮喘和 COPD 中均如此。从 pMDI 切换到 DPI 和反之亦然的情况相对常见。尽管市场上有双和三联疗法吸入器，但仍有相当数量的患者使用多种设备进行治疗。
