Need of education for dry powder inhaler storage and retention – a patient-reported survey

Mattioli1885 - Tập 11 - Trang 1-5 - 2016
Birger Norderud Lærum1,2, Gunilla Telg3, Georgios Stratelis3
1Department of Clinical Science, University of Bergen, Bergen, Norway
2Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
3AstraZeneca NordicBaltic, Södertälje, Sweden

Tóm tắt

Dry powder inhalers (DPIs) are the most commonly used devices in asthma treatment in the Nordic countries. As new DPIs become available, patients are likely to be exposed to more than one type of device, with variable optimal handling. The aim was to examine real life storage and retention of multidose DPIs in patients with asthma. This patient-reported survey on real life storage and retention of DPIs included asthma patients using multidose DPIs. Basic patient characteristics, information on inhaler use and storage, check of expiry date, and concurrent inhaler use was examined using an on line questionnaire. A total of 738 patients were included with a median age of 41 years, out of which 83 % were women. Sixty-three per cent reported storage conditions pre-defined as risk locations for their maintenance inhaler and 38 % of the responding patients had more than one maintenance inhaler in use at the same time. Two thirds of the study population checked inhaler expiry date less than monthly or not at all. Use after expiry date was frequently reported. Two thirds of the patients had not received information on DPI storage, either from their doctor and/or nurse or at the pharmacy. This patient reported survey indicates that two thirds of the patients store their inhaler devices in suboptimal conditions, and only a minority had received instruction regarding inhaler handling. Non awareness of inhalers’ expiry dates and use of more than one maintenance inhaler simultaneously was common. As inhaler mishandling may impact device functionality, improved communication and patient education is needed.

Tài liệu tham khảo

Folkehelseinstittutet. The Norwegian prescription database 2009–2013. ISBN: 978-82-8082-619-0 elektronisk utgave/electronic version (http://www.fhi.no/dokumenter/7e3ca9fffe.pdf). Accessed 18 Dec 2014. Brogger J, Bakke P, Eide GE, Johanssen B, Andersen A, Gulsvik A. Long-term changes in adult asthma prevalence. Eur Respir J. 2003;21(3):468–72. Tollefsen E, Langhammer A, Romundstad PR, Bjermer L, Johnsen R, Holmen TL. Female gender is associated with higher incidence and more stable respiratory symptoms during adolescence. Respir Med. 2007;101(5):896–902. GINA report, global strategy for asthma management and prevention. 2014; Available from: http://ginasthma.org. Accessed 19 Jan 2015. Grydeland TB, Methlie P, Bakke PS. Instructing patients in the correct use of inhalation devices (in Norwegian). Tidsskrift Nor Laegeforen. 2006;126(3):312–4. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102:593–604. Mäkele MJ, Backer V, Hedegaard M, Larsson K. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respir Med. 2013;107(10):1481–90. Papi A, Haughney J, Virchow JC, Roche N, Palkonen S, Price D. Inhaler devices for asthma: a call for action in a neglected field. Eur Respir J. 2011;37:982–5. Melani AS. Inhalatory therapy training: a priority challenge for the physician. Acta Biomed. 2007;78(3):233–45. Lavorini F, Ninane V, Haughney J, Bjermer L, Molimard M, Dekhuijzen RP. Switching from branded to generic inhaled medications: potential impact on asthma and COPD. Exp Opin Drug Deliv. 2013;10(12):1597–602. Bjermer L. The importance of continuity in inhaler device choice for asthma and COPD. Respiration. 2014;88(4):346–52. Dal Negro RW, Povero M. Acceptability and preference of three inhalation devices assessed by the handling questionnaire in asthma and COPD patients. Multidiscip Respir Med. 2016;11:7. Price D. The way forward: dry powder inhalers should only be switched with physician agreement and patient training. Int J Clin Pract Suppl. 2005;36–7. Asking L, Axelsson M, Lindberg J. Aluminium blisters may fail to protect against humidity. Drug Deliv Lungs. 1998;IX:84–7 Borgström L, Asking L, Lipniunas P. An in vivo and in vitro study comparison of two powder inhalers following storage at hot/humid conditions. J Aerosol Med. 2005;18(3):304–10. Cook C, Heath F, Russel, Thompson L. A meta-analysis of response rates in web- or internet-based surveys. Educ Psychol Meas. 2000;60:821–36. van Renswouw DC, van Laarhoven ACM, van Haren MJ, Bouvy ML, Weda M. Storage instructions for inhalation capsules: consequences of incorrect storage and adherence in daily practice. J Pharm Pract. 2010;23(6):548.