Intuitive use of multi-dose dry powder inhalers: a comparative study

Intuitive use of multi-dose dry powder inhalers: a comparative study

I.Yu. Vizel¹, A.I. Rezyapova^1,2, A.A. Vizel¹ 

¹Kazan State Medical University, Kazan

²Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan 

Aim: to determine the correct use concerning the intuitive use of four multi-dose dry powder inhalers — Turbuhaler, Genuair, Spiromax and Ellipta.

Patients and Methods: 208 subjects were included in the study. 100 patients (48.1%) had chronic obstructive lung disease (COPD) and 108 (51.9%) had asthma (A). Initially, the correct use was evaluated in three stages: 1) intuitive use before reading the medical leaflet for the dry powder inhaler (DPI); 2) after reading the medical leaflet; 3) after learning the technique of inhalation by a study doctor. Then the factors influencing the intuitive use of each of the inhalers in COPD and A were evaluated.

Results: in COPD, on an intuitive level, the Spiromax and Ellipta DPIs were three times more likely to achieve the correct technique compared to Turbuhaler and Genuair. After firmly applying the recommendations for the Genuair, Spiromax and Ellipta DPIs, patients achieved more than 80% correct use of inhalers, while in this practice the correct use of Turbuhaler reached 43%. After briefing by a doctor, Genuair, Spiromax and Ellipta were used correctly by patients with COPD in 100%, and Turbuhaler — in 93% of cases. In A, on an intuitive level, the Spiromax and Ellipta DPIs were two times more likely to achieve the correct technique compared to Turbuhaler and Genuair. Spiromax was the most intuitive (63%), whereas Genuair was the least intuitive (16.7%). After firmly applying the recommendations for the Genuair, Spiromax and Ellipta DPIs, patients achieved more than 80% correct use of inhalers, while in this practice the correct use of Turbuhaler reache d 43%. Patients with A most commonly correctly used Spiromax (95.4%) after reading the medical leaflet, and less commonly Turbuhaler (72.2%). Briefing by a doctor allowed to achieve success for all DPIs above 99%. On an intuitive level, the frequency of correct use differed between patients with COPD and A by the factors such as cognitive abilities and adherence to treatment.

Conclusion: the correct intuitive use of different DPIs of the same class and between patients with different diagnoses (COPD and A) varied, which requires an individual approach to each patient. The individual briefing by a doctor, preferably with the achievement of the maximum possible end result, plays a crucial role in the correct use of DPIs and eliminating differences in the frequency of DPI correct use.

Keywords: dry powder inhaler, chronic obstructive pulmonary disease, asthma, inhalation technique, Turbuhaler, Genuair, Spiromax, Ellipta.

For citation: Vizel I.Yu., Rezyapova A.I., Vizel A.A. Intuitive use of multi-dose dry powder inhalers: a comparative study. RMJ. 2023;1:12–17.