Assessment of satisfaction with different dry powder inhalation devices in Greek patients with COPD and asthma: the ANASA study

Abstract

Background

Poor adherence to inhaled therapy is common in patients with asthma and COPD. An inhaler selection based on patients’ preference could be beneficial to adherence and treatment effectiveness. Properly designed questionnaires can assess patients’ satisfaction with their medication devices. The aim of this study was to estimate, using the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire, the ease of use and satisfaction of patients regarding three different marketed dry powder inhalers (DPIs): Diskus^® (DK), Elpenhaler^® (EH), and Turbuhaler^® (TH). The FSI-10 is a self-completed questionnaire to assess patients’ opinions regarding ease of use, portability, and usability of devices, irrespective of the drug used.

Patients and methods

We performed a 4-week, open, noninterventional, multicenter, parallel clinical study in 560 asthmatic and 561 COPD patients. During the first visit, patients were classified into three groups according to the DPI they were already using. Patients were regularly receiving their treatments (Seretide DK, Rolenium EH, and Symbicort TH) and agreed to complete the FSI-10 questionnaire in the second visit.

Results

A total of 517 COPD and 523 asthma patients completed the study. All DPIs tested received satisfactory results, while the EH obtained consistently higher scores in the FSI-10 in both COPD and asthma patients (44.7 and 44.1 vs 41.5 and 43 for TH, 40.8 and 41.4 for DK, P<0.001 and P<0.01, respectively). TH was rated better than DK by asthma patients. Patients suffering with severe COPD tended to express higher feeling of satisfaction than those with moderate or mild disease, irrespective of the device used.

Conclusion

All DPIs tested were highly acceptable by asthma and COPD patients of different ages; nevertheless, EH received significantly higher ratings in most of the questionnaire domains. COPD patients in advanced stages of the disease generally expressed higher level of satisfaction with their devices.

Keywords:

• asthma
• COPD
• dry powder inhaler
• patient satisfaction
• FSI-10 questionnaire

Supplementary material

Table

Acknowledgments

The study was sponsored by Elpen Pharmaceuticals Co. Inc. The authors declare no third party involvement in the study design, data collection, statistical analysis and evaluation, and manuscript preparation and submission.

Disclosure

EZ has received speaker fees and conference travel grants from pharmaceutical companies, including AstraZeneca, GlaxoSmithKline (GSK), Elpen, Boehringer Ingelheim, Takeda, Novartis, Pfizer, UCB, Chiesi, Menarini, Roche, MSD, and Sherhing-Plough. Also EZ has received payment for consulting and advisory board involvement from AstraZeneca, GSK, Elpen, Novartis, and Menarini. KS has received speaker fees from Novartis and conference travel grants from Novartis, GSK, Elpen, and Demo. MG has received speaker fees and conference travel grants from pharmaceutical companies, including AstraZeneca, GSK, Elpen, Boehringer Ingelheim, Novartis, Pfizer, UCB, Chiesi, Menarini, Roche, MSD, and Sherhing-Plough. MG has also received payment for consulting and advisory board involvement from AstraZeneca, GSK, Novartis, and Boehringer Ingelheim. The authors report no other conflicts of interest in this work.