Satisfaction, preference and error occurrence of three dry powder inhalers as assessed by a cohort naïve to inhaler operation.

Background: Inhaled medication is central to the treatment of COPD. Various types of inhaler devices, which directly deliver medication to the lung, have been developed. However, patients often exhibit incorrect techniques of inhaler usage. Effectiveness of therapy may be affected by the ease of device usage, size, convenience of use, durability, clarity of instructions and device preferences of patients. This study compares the satisfaction and preference, as well as error occurrence, with the use of Genuair®, Ellipta™ and Breezhaler™ by healthy subjects in Hong Kong. Subjects and methods: One hundred and thirty healthy Hong Kong Chinese subjects aged ≥40 years without a previous diagnosis of COPD and asthma and with no experience of using dry powder inhalers (DPIs) were recruited. Subjects learned to use the three DPIs by initially reading the instructions and then observing a demonstration with verbal explanation. The number of errors committed was evaluated. Subjects also completed a questionnaire to indicate their satisfaction and preference. Results: The satisfaction score of comfort for Breezhaler was significantly higher than that for Ellipta (p≤0.05), while the satisfaction score on confidence to have inhaled the entire dose was highest for Genuair compared with Ellipta (p≤0.0001) or Breezhaler (p≤0.05). The overall satisfaction score was significantly higher for Genuair than Ellipta (p≤0.05) or Breezhaler (p≤0.01). After reading the instructions, the highest number of subjects committing one or more critical errors was with Breezhaler (97) followed by Genuair (70) and then Ellipta (33). Demonstration reduced the number of critical errors made by subjects for each DPI to one third or lower. Conclusion: Breezhaler seemed to be more comfortable and easy to carry, but users made less critical errors when using Ellipta after reading the instructions only. Genuair provided the clearest indication of correct dose preparation and inhalation.

Patient Satisfaction With Inhaled Medication for Asthma.

BACKGROUND: We sought to compare treatment satisfaction with inhaled medications among asthmatics using a metered-dose inhaler (MDI) or a dry-powder inhaler (DPI), and to correlate satisfaction with treatment adherence, pulmonary function, and airway inflammation. METHODS: Spirometry, fraction of expired nitric oxide (FENO), and asthma control were assessed in 200 adult subjects with asthma (69 men, 131 women) using MDI or DPI. Treatment satisfaction with inhaled therapy was assessed with the Treatment Satisfaction Questionnaire for Medication (TSQM) in 4 domains: Effectiveness, Side Effects, Convenience, and Global Satisfaction. The Medication Adherence Questionnaire (MAQ) was used to evaluate adherence to treatment. RESULTS: There were 115 and 85 subjects with asthma, using MDI and DPI, respectively. More MDI users (40.9%) had well-controlled asthma as compared to DPI users (17.6%). MDI users had greater treatment adherence and better TSQM domain scores for Effectiveness, Convenience, and Global Satisfaction than did DPI users. Multivariate linear regression analysis revealed no significant association between MDI/DPI use and TSQM domain scores. TSQM Convenience and Global Satisfaction domain scores were significantly correlated with MAQ scores (Spearman's coefficients 0.211 and 0.218, P = .003 and P = .002, respectively). There was no significant correlation between any TSQM domain score and pulmonary function or FENO concentration. CONCLUSIONS: MDIs were associated with better disease control and treatment adherence among subjects with asthma. Both MDI and DPI are likely to provide equivalent treatment satisfaction.