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A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices

2016; Nature Portfolio; Volume: 26; Issue: 1 Linguagem: Inglês

10.1038/npjpcrm.2016.79

2055-1010

Job van der Palen, Mike Thomas, Henry Chrystyn, Raj Kumar Sharma, Paul DLPM van der Valk, Martijn Goosens, Tom Wilkinson, Carol Stonham, Anoop Chauhan, Varsha Imber, Chang-Qing Zhu, Henrik Svedsäter, Neil Barnes,

Chronic Obstructive Pulmonary Disease (COPD) Research

Abstract Errors in the use of different inhalers were investigated in patients naive to the devices under investigation in a multicentre, single-visit, randomised, open-label, cross-over study. Patients with chronic obstructive pulmonary disease (COPD) or asthma were assigned to ELLIPTA vs DISKUS (Accuhaler), metered-dose inhaler (MDI) or Turbuhaler. Patients with COPD were also assigned to ELLIPTA vs Handihaler or Breezhaler. Patients demonstrated inhaler use after reading the patient information leaflet (PIL). A trained investigator assessed critical errors (i.e., those likely to result in the inhalation of significantly reduced, minimal or no medication). If the patient made errors, the investigator demonstrated the correct use of the inhaler, and the patient demonstrated inhaler use again. Fewer COPD patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS, 9/171 (5%) vs 75/171 (44%); MDI, 10/80 (13%) vs 48/80 (60%); Turbuhaler, 8/100 (8%) vs 44/100 (44%); Handihaler, 17/118 (14%) vs 57/118 (48%); Breezhaler, 13/98 (13%) vs 45/98 (46%; all P <0.001). Most patients (57–70%) made no errors using ELLIPTA and did not require investigator instruction. Instruction was required for DISKUS (65%), MDI (85%), Turbuhaler (71%), Handihaler (62%) and Breezhaler (56%). Fewer asthma patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS (3/70 (4%) vs 9/70 (13%), P =0.221); MDI (2/32 (6%) vs 8/32 (25%), P =0.074) and significantly fewer vs Turbuhaler (3/60 (5%) vs 20/60 (33%), P <0.001). More asthma and COPD patients preferred ELLIPTA over the other devices (all P ⩽0.002). Significantly, fewer COPD patients using ELLIPTA made critical errors after reading the PIL vs other inhalers. More asthma and COPD patients preferred ELLIPTA over comparator inhalers.