Patients’ sensory perception and satisfaction with use of metered dose inhalers and dry powder inhalers in moderate persistent asthma
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20193609Keywords:
Asthma, Dry powder inhalers, Metered dose inhalers, Patient satisfaction, Sensory perceptionAbstract
Background: Inhalers containing corticosteroid and a long acting β2 agonist (LABA) are widely used in asthma treatment. This study assessed the patient sensory perception and satisfaction of budesonide/formoterol fixed dose combination by pressurized metered dose inhalers (pMDI) with spacer and dry powder inhalers (DPI) in patients of moderate persistent asthma.
Methods: This was a 6 week prospective, randomized, open label, comparative, parallel group clinical study. All patients had a forced expiratory volume in 1 second (FEV1) of 60-80% predicted normal. The patients were assessed for sensory perception and satisfaction in group I (pMDIs with spacers) and group II (DPIs) using patient evaluation questionnaire (PEQ) and patient satisfaction and preference questionnaire (PASAPQ) at the end of 6th week.
Results: In PEQ, statistical analysis of the mean attribute ratings showed that both the devices were easy to use by patients. More medication was felt reaching throat using DPIs. Patients on DPI liked the taste and felt it to be less strong than patients on pMDIs. The overall liking was statistically comparable in two groups. In PASAPQ, the patients on DPI group were very satisfied with the treatment than pMDI (p<0.05).
Conclusion: Overall liking of both DPIs and pMDIs was comparable and patients on DPI were satisfied more with the treatment device. Patient sensory perception and satisfaction may be taken into account in selecting device to improve compliance to treatment.
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References
The Global Asthma Report. c2018. Available at: www.globalasthmareport.org. Accessed on 30 May 2019.
Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults. Int J Tuberc Lung Dis. 2012;16(9):1270-7.
Dolovich M. New Delivery systems and propellants. Can Respir J. 1999;6(3):290-5.
Togger D, Brenner P. Metered dose inhalers. Am J Nurs. 2001;101:29-32.
Newman SP. Spacer devices for metered dose inhalers. Clin Pharmacokinet. 2004;43(6):349-60.
Harris DS, Smith SJ. Dry Powder Inhaler. United States Patent No. US8261739B2. 2012. Available at: https://patents.google.com/patent/US8261739B2/en. Accessed on 15 May 2015.
Finlay WH. The mechanics of inhaled pharmaceutical aerosols: an introduction, 1st edn. Boston: Academic Press; 2001:47-91.
Voss A, Finlay WH. Deagglomeration of dry powder pharmaceutical aerosols. Int J Pharm. 2002;248(1-2):39-50.
Arora P, Kumar L, Vohra V, Sarin R, Jaiswal A, Puri MM et al. Evaluating the technique of using inhalation device in COPD and bronchial asthma patients. Respir Med. 2014;108(7):992-8.
Sestini P, Cappiello V, Aliani M, Martucci P, Sena A, Vaghi A. Prescription bias and factors associated with improper use of inhalers. J Aerosol Med. 2006;19(2):127-36.
Lee SM, Chang YS, Kim CW, Kim TB, Kim SH, Kwon YE, et al. Skills in handling Turbuhaler, Diskus, and pressurized Metered-Dose Inhaler in Korean asthmatic patients. Allergy Asthma Immunol Res. 2011;3(1):46-52.
Rootmensen GN, Van Keimpema ARJ, Jansen HM, De Haan RJ. Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323-8.
Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002;19(2):246-51.
Wieshammer S, Dreyhaupt J. Dry powder inhalers: which factors determine the frequency of handling errors? Respiration. 2008;75(1):18-25.
Bunnag C, Fuangtong R, Pothirat C, Punyaratabandhu P. A comparative study of patients’ preferences and sensory perceptions of three forms of inhalers among Thai asthma and COPD patients. Asia Pac Allergy Immunol. 2007;25(2-3):99.
Ramadan WH, Sarkis AT. Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: An observational comparative study. Chronic Respiratory Dis. 2017;14(3):309-20.
Aggarwal AN, Kumari R, Grover S. Patient satisfaction with inhaled medication for asthma. Respir Care 2018;63(7):859-64.
Anderson P. Patient preference for and satisfaction with inhaler devices. Eur Resp Rev. 2005;14(96):109-16.
Kozma CM, Slaton TL, Monz BU, Hodder R, Reese PR. Development and validation of a patient satisfaction and preference questionnaire for inhalation devices. Treat Respir Med. 2005;4(1):41-52.
Khilnani GC, Banga A. Aerosol Therapy. JIACM. 2004;5:114-23.
Ross DL, Schultz RK. Effect of inhalation flow rate on the dosing characteristics of dry powder inhaler (DPI) and metered dose inhaler (MDI) products. J Aerosol Med. 1996;9(2):215-26.
Miravitlles M, Montero-Caballero J, Richard F, Santos S, Garcia-Rivero JL, Ortega F et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:407-15.