John Haughney, David Price, Neil C. Barnes, J

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Presentation transcript:

Choosing inhaler devices for people with asthma: Current knowledge and outstanding research needs John Haughney, David Price, Neil C. Barnes, J. Christian Virchow, Nicolas Roche, Henry Chrystyn Respiratory Medicine CME Volume 3, Issue 3, Pages 125-131 (January 2010) DOI: 10.1016/j.rmedc.2010.10.004 Copyright © 2010 Elsevier Ltd Terms and Conditions

Figure 1 (a) Frequency of critical handling errors made by patients with asthma and/or chronic obstructive pulmonary disease when using four different types of dry powder inhalers (trade names changed to types A–D). The first attempt was made after patients read the device instructions, and the second attempt was made after the investigator explained device handling. Adapted from Schulte et al.13 (b) Percentage of patients with uncontrolled asthma who failed to use their pMDIs correctly, as tested with an Aerosol Inhalation Monitor (AIM, Vitalograph®, Vitalograph, Ltd, Buckingham, England). The second and third tests were performed after instruction on pMDI technique. Adapted from Hardwell et al.14 Respiratory Medicine CME 2010 3, 125-131DOI: (10.1016/j.rmedc.2010.10.004) Copyright © 2010 Elsevier Ltd Terms and Conditions

Figure 2 Outcome of asthma treatment during study year 2 for patients whose inhaled corticosteroid device was switched without an accompanying consultation (switched cohort) and matched controls: percentages of patients experiencing successful asthma treatment, partially successful treatment, and unsuccessful treatment. Reprinted from Thomas et al.21 Respiratory Medicine CME 2010 3, 125-131DOI: (10.1016/j.rmedc.2010.10.004) Copyright © 2010 Elsevier Ltd Terms and Conditions

Figure 3 Location of targets for bronchodilators. Adapted from Carstairs et al.,26 Mak and Barnes,27 and Jeffery.28 Respiratory Medicine CME 2010 3, 125-131DOI: (10.1016/j.rmedc.2010.10.004) Copyright © 2010 Elsevier Ltd Terms and Conditions

Figure 4 Schematic depicting the relationship between particle emission rate from a dry powder inhaler (DPI; capsule & reservoir/blister type) and patient inhalation profiles that are usual vs. ideal for DPI dose emission. Actual shape will vary with device used. Adapted with permission from Chrystyn and Price.45 Respiratory Medicine CME 2010 3, 125-131DOI: (10.1016/j.rmedc.2010.10.004) Copyright © 2010 Elsevier Ltd Terms and Conditions