Inappropriate use of inhalers

Inhalation step by step: What your patients SHOULD be doing Step 1: Remove the cap from the inhaler. Step 2: Shake the inhaler well for 5 seconds. Step 3: Hold the inhaler firmly by placing your index finger on top of the canister, and thumb on the bottom of the mouthpiece. Step 4: Sit straight or stand up. Step 5: Tilt your head back slightly. Step 6: Exhale away from the inhaler. Step 7: Put the inhaler in your mouth. Press the inhaler and start breathing in at the same time. Take a slow and deep breath. Step 8: Hold your breath for 10 seconds. Exhale slowly through your mouth or nose.

Easier to use a spacer

Asthma & COPD in the UK The British Thoracic Society Guidelines/Scottish Intercollegiate Guidelines Network/NICE guidelines provide evidenced Based Platforms for the management of patients with these conditions. The local health economies within the UK will only approve funding for specific projects if they meet the quality, innovation, productivity and prevention requirements of QIPP. In terms of how this translates to prescribing, within the UK, prescribing follows the guidelines within the BTS steps 1-5. Over the last 10years, but particularly over the last 5 years there has been an erosion of patients at step 2 of the BTS guidelines, with patients being established onto step 3 earlier i.e. combination therapy. Step 3 medication is significantly more expensive than step 2 and there are real concerns that patients who could be managed effectively at step 2 of the BTS guidelines are being initiated onto step 3 therapy and creating a cost burden to the tax payer. In addition patients who are controlled at step 3 are not being titrated downward to step 2 as also underlined in the guidelines. In many cases the reason for the poor asthma control can be attributed to the fact that a large number of patients are not taking their preventer therapy regularly or indeed cannot use their pMDI inhaler effectively. The addition of a spacer device or alternatively a change of inhaler device to another step 2 therapy for these patients would represent a significant cost saving for the NHS. In particular many localities recognise that pMDIs are difficult to use and that the addition of a spacer device is an extremely cost-effective intervention to prevent patients progressing to step 3. Indeed several localities have stipulated that any patient being prescribed a pMDI should always be co-prescribed a spacer. “ Eddie Mcknight, Managing Director, NSHI Ltd “

Spacer Chambers on the market in the UK

The Compact Space Chamber Plus Overview. Fits multiple pMDI connections due to flexible rubber connection, round and shaped 22 mm connection for standard mask fit 15 mm ISO standard Connection to attach a tracheostomy directly Oval shaped mouth piece for greater comfort Clear visibility of the valve moving allowing positive reinforcement of medication administration Clean life long glass like polycarbonate body giving a new look for 12 months Dishwasher proof, guaranteed for 12 months Very Low resistance allows the valve to open wide allowing aerosol to pass to the patient on inhalation

Asthma UK help line Medical Developments UK (MDUK) has become a silver corporate partner of Asthma UK, the UK’s leading asthma charity. As part of the agreement, MDUK will donate 25p to the charity from the sale of each of its spacers in the UK, including both the Space Chamber plus® and the Space Chamber plus Compact ®. Asthma UK’s Clinical Lead Deborah Waddell said: “We know that the Space Chamber plus® is popular with patients and clinicians, so we are very pleased to welcome MDUK to our corporate partnership scheme The Asthma UK Helpline number is (open Monday to Friday 9-5pm) MDUK is supporting Asthma UK to bring improved techniques to asthma patients. 25p from the sale of each unit of the Space Chamber Plus, Combo Space Chamber Plus, Compact Space Chamber Plus and Combo Compact Space Chamber Plus will be donated to Asthma UK, a registered charity, no

Medical Testimonials “We were very impressed with the Space Chamber Plus – with a low resistance valve, it’s easy to see when the spacer is being used correctly and it’s very useful to be able to connect easily to a tracheotomy tube. We were also pleased to note that this spacer is dishwasher safe.” Vicky Taylor Practice Nurse, Northants

Equivalence in vitro testing In vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber Plus Flow Vu™ Anti ‐ static, and Aerochamber Plus Flow Vu™ Study ObjectiveStudy Objective: To compare drug output and aerodynamic particle size distribution of combination inhalers, for the treatment of both the bronchoconstriction and inflammatory aspects of asthma and chronic obstructive pulmonary disease (COPD), when delivered from different valved holding chambers (VHCs): Space Chamber Plus (SCP), Compact Space Chamber Plus (CSCP), Aerochamber Plus Flow Vu and Aerochamber Plus Flow Vu Anti ‐ static. Conclusion: Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non ‐ antistatic valved holding chambers, Chamber Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Antistatic, and non ‐ antistatic Aerochamber Plus Flow Vu. Both Space Chamber Plus and Compact Space Chamber Plus are made of the same materials. The shorter length of the Compact Space Chamber Plus easily fits into school bags, handbags or briefcases to allow easier storage and handling. Both VHCs have a transparent body so that the respiratory valves and their movement can be easily seen and therefore enables the confirmation of correct product operation and usage In vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber Plus Flow Vu™Anti ‐ static Study Objective: To compare particle size distribution, and therefore in vitro performance, of three different classes of drug (albuterol sulfate, beclomethasone Dipropionate and ipratropium bromide) when delivered from three different valved holding chambers (VHCs). Conclusion: Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non ‐ antistatic VHCs, Space Chamber Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Anti ‐ static.

Features of the MDI Spacer Chamber ® Unique patented Cross-Valve technology TM Universal end suitable for all Meter Dose Inhalers Compact design Very low resistance ensures more than 20% respirable particle delivery compared to other established spacer products 1 Transparent design to allow you to see medication delivery and cross valve functionality Can be used with any international standard respiratory facemask Enables unrestricted and continuous breathing Deigned with detachable mask to enhance children to move up to without mask inhalation but with the security of having a mask if needed in one device No whistle as it leads to confusion and misunderstanding in patients Open Closed

For Use by the old and young, COPD and Asthma patients