PT  - JOURNAL ARTICLE
AU  - M Chakma
AU  - S Meah
AU  - M Biddiscombe
AU  - D Murnane
AU  - O Usmani
TI  - Dry powder inhaler (DPI) resistance: human behaviour and psychology of patient inspiratory effort
AID  - 10.1183/13993003.congress-2022.435
DP  - 2022 Sep 04
TA  - European Respiratory Journal
PG  - 435
VI  - 60
IP  - suppl 66
4099  - http://erj.ersjournals.com/content/60/suppl_66/435.short
4100  - http://erj.ersjournals.com/content/60/suppl_66/435.full
SO  - Eur Respir J2022 Sep 04; 60
AB  - Background: DPI airflow resistance (Af-Rs) may influence how respiratory patients perceive inhaler performance. Yet, limited data exists on how patients perceive the process of active inhalation (‘inhale-ability’) and whether their perception of Af-Rs affects their attitudes towards a certain DPI.Aim: Explore the psychological and physiological aspects of patients’ inspiratory effort through DPIs with different Af-Rs to develop an ‘inhale-ability’ questionnaire for evaluating the patients’ perception to Af-Rs.Method: Patients (COPD, asthma) of different disease severities participated in focus groups and semi-structured cognitive audio-recorded interviews that were transcribed to allow for coding of data and thematic analysis to cluster the emerging themes.Results: COPD (n=26; age=67.2yr [SD=7.1]; FEV1=1.6L [SD=0.65]; education=National Qualifications Framework (NQF) level 2 [range=0-6]) and asthma patients (n=26; age=54.2yr [SD=14.5]; FEV1=2.5L [SD=0.85]; education=NQF level 6 [range=1-8]) associated inspiratory effort with 3 key themes: 1-Routine, 2-Confidence, 3-Control. The DPI administration routine appeared to be the greatest influence in 85%, regardless of the perceived difficulty of a DPI’s Af-Rs. Although all 52 patients acknowledged the role of confidence, this was the second most important factor (80%). Surprisingly, only 58% felt they could control their inspiratory effort for a given DPI.Conclusion: Our results suggest that perception of inspiratory effort is variable across asthma and COPD patients and may be influenced by interpretation of the observed 3 themes. Studies need to evaluate how these themes can gauge patient perception to Af-Rs. Funded by U.S. FDA.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 435.This article was presented at the 2022 ERS International Congress, in session “-”.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).