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What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape

Inhaled therapies are the cornerstone of treatment in asthma and chronic obstructive pulmonary disease, and there are a multitude of devices available. There is, however, a distinct lack of evidence-based guidance for healthcare providers on how to choose an appropriate inhaler. This review aims to...

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Autores principales: Lavorini, Federico, Janson, Christer, Braido, Fulvio, Stratelis, Georgios, Løkke, Anders
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900625/
https://www.ncbi.nlm.nih.gov/pubmed/31805823
http://dx.doi.org/10.1177/1753466619884532
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author Lavorini, Federico
Janson, Christer
Braido, Fulvio
Stratelis, Georgios
Løkke, Anders
author_facet Lavorini, Federico
Janson, Christer
Braido, Fulvio
Stratelis, Georgios
Løkke, Anders
author_sort Lavorini, Federico
collection PubMed
description Inhaled therapies are the cornerstone of treatment in asthma and chronic obstructive pulmonary disease, and there are a multitude of devices available. There is, however, a distinct lack of evidence-based guidance for healthcare providers on how to choose an appropriate inhaler. This review aims to summarise recent updates on topics related to inhaler choice, and to offer practical considerations for healthcare providers regarding currently marketed devices. The importance of choosing the right inhaler for the right patient is discussed, and the relative merits of dry powder inhalers, pressurised metered dose inhalers, breath-actuated pressurised metered dose inhalers, spacers and soft mist inhalers are considered. Compiling the latest studies in the devices therapy area, this review focuses on the most common types of handling errors, as well as the comparative rates of incorrect inhalation technique between devices. The impact of device-specific handling errors on inhaler performance is also discussed, and the characteristics that can impair optimal drug delivery, such as inhalation flow rate, inhalation volume and particle size, are compared between devices. The impact of patient perceptions, behaviours and problems with inhalation technique is analysed, and the need for appropriate patient education is also highlighted. The continued development of technology in inhaler design and the need to standardise study assessment, endpoints and patient populations are identified as future research needs. The reviews of this paper are available via the supplemental material section.
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spelling pubmed-69006252019-12-13 What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape Lavorini, Federico Janson, Christer Braido, Fulvio Stratelis, Georgios Løkke, Anders Ther Adv Respir Dis Review Inhaled therapies are the cornerstone of treatment in asthma and chronic obstructive pulmonary disease, and there are a multitude of devices available. There is, however, a distinct lack of evidence-based guidance for healthcare providers on how to choose an appropriate inhaler. This review aims to summarise recent updates on topics related to inhaler choice, and to offer practical considerations for healthcare providers regarding currently marketed devices. The importance of choosing the right inhaler for the right patient is discussed, and the relative merits of dry powder inhalers, pressurised metered dose inhalers, breath-actuated pressurised metered dose inhalers, spacers and soft mist inhalers are considered. Compiling the latest studies in the devices therapy area, this review focuses on the most common types of handling errors, as well as the comparative rates of incorrect inhalation technique between devices. The impact of device-specific handling errors on inhaler performance is also discussed, and the characteristics that can impair optimal drug delivery, such as inhalation flow rate, inhalation volume and particle size, are compared between devices. The impact of patient perceptions, behaviours and problems with inhalation technique is analysed, and the need for appropriate patient education is also highlighted. The continued development of technology in inhaler design and the need to standardise study assessment, endpoints and patient populations are identified as future research needs. The reviews of this paper are available via the supplemental material section. SAGE Publications 2019-12-06 /pmc/articles/PMC6900625/ /pubmed/31805823 http://dx.doi.org/10.1177/1753466619884532 Text en © The Author(s), 2019 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Lavorini, Federico
Janson, Christer
Braido, Fulvio
Stratelis, Georgios
Løkke, Anders
What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title_full What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title_fullStr What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title_full_unstemmed What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title_short What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
title_sort what to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900625/
https://www.ncbi.nlm.nih.gov/pubmed/31805823
http://dx.doi.org/10.1177/1753466619884532
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