Preference, satisfaction and critical errors with Genuair and Breezhaler inhalers in patients with COPD: a randomised, cross-over, multicentre study.

Sergi Pascual,Jan Feimer,Anthony De Soyza,Ludmyla Rekeda,Anna Ribera,Jaume Sauleda Roig,Henry Chrystyn,Laura Padullés,Beatriz Seoane,John Haughney

doi:10.1038/npjpcrm.2015.18

Abstract

Background:The specific attributes of inhaler devices can influence patient use, satisfaction and treatment compliance, and may ultimately impact on clinical outcomes in patients with chronic obstructive pulmonary disease (COPD).Aims:To assess patient preference, satisfaction and critical inhaler technique errors with Genuair (a multidose inhaler) and Breezhaler (a single-dose inhaler) after 2 weeks of daily use.Methods:Patients with COPD and moderate to severe airflow obstruction were randomised in a cross-over, open-label, multicentre study to consecutive once-daily inhalations of placebo via Genuair and Breezhaler, in addition to current COPD medication. The primary end point was the proportion of patients who preferred Genuair versus Breezhaler after 2 weeks (Patient Satisfaction and Preference Questionnaire). Other end points included overall satisfaction and correct use of the inhalers after 2 weeks, and willingness to continue with each device.Results:Of the 128 patients enrolled, 127 were included in the safety population (male n=91; mean age 67.6 years). Of the 110 of the 123 patients in the intent-to-treat population who indicated an inhaler preference, statistically significantly more patients preferred Genuair than Breezhaler (72.7 vs. 27.3%; P<0.001). Mean overall satisfaction scores were also greater for Genuair than for Breezhaler (5.9 vs. 5.3, respectively; P<0.001). After 2 weeks, there was no statistically significant difference in the number of patients who made ⩾1 critical inhaler technique error with Breezhaler than with Genuair (7.3 vs. 3.3%, respectively).Conclusions:Patient overall preference and satisfaction was significantly higher with Genuair compared with Breezhaler. The proportion of patients making critical inhaler technique errors was low with Genuair and Breezhaler.

Highlights

There are numerous inhaler devices available for the delivery of bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD): for example, dry-powder inhalers (DPIs), pressurised metered-dose inhalers, soft mist inhalers and nebulisers.[1,2,3] Each inhaler has advantages and disadvantages that may impact on a patient’s use, satisfaction and compliance with therapy, and affect clinical outcomes.[4,5] Choosing the most appropriate inhaler for a patient is likely to positively influence their attitude to COPD, improve adherence to therapy and, have therapeutic benefits.[4]
Issues relating to incorrect inhaler technique may be worsened because many patients with COPD require multiple inhaled therapies, which are often administered via separate inhalers that require distinct inhalation techniques for optimal use.[5,8,13]
127 patients were included in the safety population and in the intent-to-treat population; patients completed the study (Figure 2)

Summary

Introduction

There are numerous inhaler devices available for the delivery of bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD): for example, dry-powder inhalers (DPIs), pressurised metered-dose inhalers, soft mist inhalers and nebulisers.[1,2,3] Each inhaler has advantages and disadvantages that may impact on a patient’s use, satisfaction and compliance with therapy, and affect clinical outcomes.[4,5] Choosing the most appropriate inhaler for a patient is likely to positively influence their attitude to COPD, improve adherence to therapy and, have therapeutic benefits.[4]. The specific attributes of inhaler devices can influence patient use, satisfaction and treatment compliance, and may impact on clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). AIMS: To assess patient preference, satisfaction and critical inhaler technique errors with Genuair (a multidose inhaler) and Breezhaler (a single-dose inhaler) after 2 weeks of daily use. The primary end point was the proportion of patients who preferred Genuair versus Breezhaler after 2 weeks (Patient Satisfaction and Preference Questionnaire). Of the 110 of the 123 patients in the intent-to-treat population who indicated an inhaler preference, statistically significantly more patients preferred Genuair than Breezhaler (72.7 vs 27.3%; P o 0.001). After 2 weeks, there was no statistically significant difference in the number of patients who made ⩾ 1 critical inhaler technique error with Breezhaler than with Genuair (7.3 vs 3.3%, respectively). The proportion of patients making critical inhaler technique errors was low with Genuair and Breezhaler

Objectives

Results

Discussion

Conclusion