Prevalence and clinical predictors of inhaler discordance in COPD: an observational study

Abstract

Background: Inhaler discordance (peak inspiratory flow rate (PIFR) mismatch with inhalers) was recently reported among chronic obstructive pulmonary disease (COPD) cohort. Aims and Objectives: The aim of this study was to determine prevalence and possible clinical predictors of inhaler discordance based on patient PIFR. Methods: A prospective, observational study was conducted including 180 COPD subjects before hospital discharge. PIFR was measured across all resistance ranges of In-Check Dial®. COPD subjects were defined as discordant if measured PIFR was suboptimal with any resistance (R1-R5). Demographics, COPD Assessment Test (CAT), modified Medical Research Council (mMRC) scores, Global Initiative for Obstructive Lung Disease (GOLD) stage and group were recorded. Spirometry was measured by Spirodoc® and peak flow rates with portable peak inspiratory and expiratory flow meters. All were correlated with In-Check Dial PIFRs. Results: Discordance was 44.44% prevalent in COPD subjects at hospital discharge (55% females). In the discordant cohort, CAT score was significantly higher and spirometry demonstrated significantly lower lung function results compared to the concordant cohort (p Conclusions: PIFR discordance is common among COPD subjects (mainly female gender) at hospital discharge and peak flow meter PIFR was the main predictor of discordance which is recommended to personalize COPD patient inhaler therapy.