Maintenance inhaler preference, attribute importance, and satisfaction in prescribing physicians and patients with asthma, COPD, or asthma–COPD overlap syndrome consulting for routine care

Abstract

Background

In respiratory disorders, patient- and physician-perceived satisfaction with the maintenance inhaler device is an important factor driving treatment compliance and outcomes. We examine inhaler preferences in asthma and COPD from patient and physician perspectives, particularly focusing on the relative importance of individual device attributes and patient characteristics guiding inhaler choice.

Materials and methods

Real-world data from >7,300 patients with asthma, COPD, or asthma–COPD overlap syndrome (ACOS) consulting for routine care were derived from respiratory Disease Specific Programs conducted in Europe, USA, Japan, and China. Outcome variables included current pattern of inhaled maintenance therapy and device type, physician preference, patient-reported device attribute importance, and satisfaction.

Results

The most commonly prescribed inhalers for maintenance therapy of asthma, COPD, and ACOS were dry powder inhalers (62.8%–88.5% of patients) and pressurized metered dose inhalers (18.9%–35.3% of patients). One-third of physicians stated no preference for maintenance device when prescribing treatment, and less than one-third of patients reported being “extremely satisfied” with any attribute of their device. Instructions being “simple and easy to follow” was the inhaler attribute most commonly selected as important. For approximately one-third of patients across all groups, “ease of use/suitability of inhaler device” was a reason for the prescribing decision, as stated by the physician. Device characteristics were more likely to impact the prescribing decision in older patients (in asthma and COPD; P<0.01) and those with worse disease severity (in COPD; P<0.001).

Conclusion

A relatively high proportion of physicians had no preference for inhaler type across asthma, COPD, and ACOS. Simplicity of use was the most important inhaler attribute from a patient’s perspective. Physicians appeared to place most importance on ease of use and device suitability when selecting inhalers for older patients and those with more severe disease, particularly in COPD.

Keywords:

• inhaler preference
• patient preference
• maintenance therapy
• COPD
• asthma
• routine care

Acknowledgments

Medical writing support, under the direction of the authors, was provided by Thomas Owens PhD and Caroline Shepherd BPharm of CMC CONNECT, a division of Complete Medical Communications Ltd, Macclesfield, UK, funded by AstraZeneca, Cambridge, UK, in accordance with Good Publication Practice (GPP3) guidelines.²⁹ The authors wish to thank James Pike, a senior statistician and employee of Adelphi Real World, who provided analytical support. The study was supported by AstraZeneca. Data in this paper were, in part, presented at the American Thoracic Society International Conference, San Francisco, CA, USA, 13–18 May 2016 as a poster presentation. The poster’s abstract was published in the abstract issue of Am J Respir Crit Care Med 2016;193:A1685: http://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_Meeting-Abstracts.A1685.

Author contributions

All authors contributed toward data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.

Disclosure

BD, GS, and UH are employees of AstraZeneca. MS is an employee of Adelphi Real World. The authors report no other conflicts of interest in this work.