Abstract
Introduction: Inhalation treatment and choice of inhaler is essential in patients with COPD. However, no evidence-based recipe of how to select the right inhaler exist.
Aim: To investigate how to do a qualified inhalation check with the purpose of assisting to the most proper device selection in patient with COPD.
Method: The assessments were performed by experienced respiratory nurses (ERN) from six specialized departments of pulmonology in Central Denmark Region. In total 12 ERN received intensive training and reached consensus regarding correct use of the aids via workshops prior to the intervention and at an ongoing basis.
571 consecutive patients (male = 51,4%), mean age 70,2, mean FEV1 45% were tested with respect to inspiratory flow/capacity using the following aids:
In-check Dial (ID)
Turbohaler test-flute Vitalograph (TF)
Vitalograph AIM (Aerosol Inhalation Monitor)
Relevant placebo inhaler (PI)
Results: 86% (n=491) demonstrated an inspiratory flow on ID ≥ 45 L/min.
67% were assessed with TF and 52% with AIM to have sufficient inspiratory flow and duration for dry powder inhaler (DPI).
Overall consistency between the 3 different aids was 54%.
30% (108 out of 363) of the patients using DPI were in need of device change.
Tested with PI the following results emerged:
Method: Not ok 25% (85 of 335)
Pressurized metered dose inhaler: Not ok 50% (21 of 42)
Soft Mist: Not ok 18% (42 of 227)
In total, 27% (4-43%) off the patients were eventually changed in device based on the combined conclusion.
Conclusion: Using only one aid when testing inhalation technique is insufficient. Therefore, we recommend to measure both inspiratory flow/capacity and to use PI before deciding on the most proper inhaler.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 630.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020