TY - JOUR T1 - Comparison of first experience with different inhalers in COPD: a cross-over study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4016 VL - 56 IS - suppl 64 SP - 4016 AU - Hadeer S. Harb AU - Nabila Ibrahim Laz AU - Hoda Rabea AU - Mohamed E.A. Abdelrahim Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4016.abstract N2 - Background: Inhalers mishandling remains common in real-life and is associated with poor clinical control.Aims and Objectives: This study aimed to compare different inhalers handling by chronic obstructive pulmonary disease (COPD) patients with no past-experience.Methods: In this open-label, cross-over study, 180 COPD patients were randomized to handle 10 placebo inhalers including pressurized metered dose inhaler (pMDI), Aerolizer, Handihaler, Turbohaler, Diskus, Breezhaler, Ellipta, Easyhaler, Diskhaler and Respimat without receiving any instructions. Inhalers with a reported past-experience were excluded. The correct use of the inhaler was then demonstrated and patient was reevaluated. Demonstration was repeated till a complete right handling. Total correct handling steps and number of counseling attempts were recorded.Results: Mean±SD percentages of total correct steps were 50.08±18.70, 52.13±15.80, 57.89±14.38, 59.52±17.46, 63.54±10.36, 66.98±15.96, 71.87±17.36, 73.33±11.46, 77.08±13.82 and 85.95±11.42% for Respimat, pMDI, Diskhaler, Diskus, Aerolizer, Handihaler, Easyhaler, Turbohaler, Breezhaler and Ellipta respectively with p<0.001. Ellipta showed the highest percentage of participants with a complete right handling with no counseling (20%) and with one counseling attempt (77.78%). On the other hand, Diskhaler, pMDI and Respimat were the only inhalers included in a forth counseling attempt.Conclusion: Inhalers greatly vary in their ease of use ranging from easy inhalers like Ellipta to intermediate inhalers like Easyhaler and Handihaler followed by difficult inhalers like pMDI and Respimat which necessitates repeated counseling when prescribing inhalers for the first time.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4016.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). ER -