Abstract
Objective: To study the influence of type of inhalation device on adherence of COPD patients to inhaled medication.
Methods: Therapy adherence of 795 patients was recorded from pharmacy records over 3 years. It was expressed as percentage and was deemed good at 75–125%, sub-optimal 50-75%, and poor <50% or >125%. Some patients used more than one medication, so we present 1377 medication periods.
Results: Patients using a Cyclohaler have a 7-fold increased risk of suboptimal adherence versus good adherence compared to the Handihaler; for Metered Dose Inhaler (MDI) and Diskus 2.3 and 2.2 times as high, respectively. (table 1)
Patients using a MDI, Diskus or Autohaler have a 2.0; 2.2 and 6.8-fold increased risk of poor <50% versus good adherence compared to a Handihaler. Patients using a MDI, Autohaler, Turbuhaler or Cyclohaler have an increased risk of poor (>125%) versus good adherence compared to a Handihaler.
Conclusions: Handihaler showed the highest adherence. MDI, Autohaler, Turbuhaler and Cyclohaler have a higher risk of overuse compared to Handihaler. MDI, Diskus and Autohaler show an increased risk of underuse.
- © 2013 ERS