Medicine of the Future in America

Patient Handling of a Multidose Dry Powder Inhalation Device for Albuterol: Patient Performance

Following a demonstration by the investigator, 74 percent of patients were able to perform all maneuvers correctly on their first attempt. Approximately 98.5 percent of patients could perform all steps correctly after three attempts. Thirty patients were withdrawn because of failure to perform all steps correctly after three attempts. Performance difficulties at the initial visit resulting in exclusion from the trial were infrequent but more common in the elderly (3 percent vs 0.2 percent for all other age groups combined, p<0.001). At the initial visit, the most common errors occurred when loading the disk into the inhaler (Table 1). After at least 2 weeks of treatment, 89.2 percent of patients performed the different maneuvers correctly with 4.2 percent of patients unable to do so. Data were unavailable for 6.6 percent of the patients itat on canadian neighbor pharmacy. At the conclusion of the trial, incorrect use of the disk device was noted in 10.2 percent of the elderly and 3.2 percent of all other age groups combined (p<0.001). By contrast to the initial visit, the most common error at the conclusion of the trial was in cleaning the device. This was the most successfully performed maneuver at the initial visit (Table 2).
At the end of the study, 89 percent of the returned devices were working correctly and 1 percent were not functioning properly; however, data were unavailable for 10 percent of patients.
The disk device was preferred by the majority of patients who previously used dry powder inhalers and by slightly over half of the patients who previously used an MDI (p<0.001 for both) (Table 3). The majority of pediatric patients preferred the disk delivery system to their previous inhalation device (p<0.001). Approximately half of the adult and the elderly population preferred the disk delivery system to their previous inhaler device (p<0.001) (Table 4). In total, 54 percent of patients preferred the disk device to their previous device (p<0.001), 29 percent preferred their previous device, 12 percent expressed no preference, and 5 percent did not give their opinion. There was no difference in patient preference by gender; 55 percent of female and 54 percent of male patients preferred the disk device over their previous ^-agonist inhaler.

Table 3—Patient Preference for Delivery System According to Previous Device

PreviousDevice Device, %
Diskhaler PreviousDevice No Preference or Not Stated
MDI 52 31 17
MDI + spacer 55 30 15
Dry powder 68 18 14
Other 59 20 21
Total 54 29 17

Table 4—Patient Preference for Delivery System According to Age Group

Age, yr Device, %
Diskhaler PreviousDevice No Preference or Not Stated
<13 78 9 13
13-64 49 33 18
>64 52 33 15
Total 54 29 17
This entry was posted in Pulmonary function and tagged albuterol, asthma, blisters ventodisk, cough, inhaler.
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