A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD

Abstract

Delivery of inhaled medications via an inhaler device underpins the effectiveness of treatment for patients with chronic obstructive pulmonary disease (COPD). Correct inhaler technique among patients is also a predictor of achieving treatment compliance and adherence. Reporting of patient satisfaction with inhalers is therefore gaining increasing attention and is now recognized as an important patient-reported outcome in clinical trials involving patients with COPD or asthma. In this cross-sectional study, we use the validated Patient Satisfaction and Preference Questionnaire (PASAPQ) to assess the handling and satisfaction for Respimat^® Soft Mist™ Inhaler (SMI) compared with the Breezhaler^® dry powder inhaler (DPI) among patients with COPD in Spain. Patients were already assigned to therapy with either SPIRIVA^® (tiotropium) Respimat^® or with Hirobriz^®/Onbrez^®/Oslif^® (indacaterol) Breezhaler^® for at least 3 but not more than 6 months before completing the PASAPQ at a single visit to the study site. The primary endpoint of the trial was the mean total PASAPQ score. Secondary endpoints were the performance score domain of the PASAPQ, the convenience score domain of the PASAPQ, and the overall satisfaction score of the PASAPQ. For the primary endpoint, the mean PASAPQ total score in the Respimat^® and Breezhaler^® groups was 80.7 and 79.9, respectively (difference of 0.8, 95% confidence interval [CI] −2.9 to 4.5; P=0.67). The mean total performance scores were 82.5 and 78.2 (difference of 4.3, 95% CI −0.3 to 8.9; P=0.06), and the mean total convenience scores were 78.6 and 81.9 (difference of −3.3, 95% CI −7.0 to 0.4; P=0.08) for the Respimat^® and Breezhaler^® groups, respectively. Patients gave the Respimat^® SMI and the Breezhaler^® DPI overall satisfaction PASAPQ scores of 6.0 and 5.9, respectively, which shows that patients were satisfied with these inhalers.

Keywords:

• COPD
• Respimat^®
• Breezhaler^®
• inhaler
• handling

Supplementary material

Table S1 Validated questions included in the modified PASAPQ

Acknowledgments

Writing assistance was provided by Godfrey Lisk, of PAREXEL, funded by Boehringer Ingelheim.

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

Marc Miravitlles has received speaker fees from Almirall, Boehringer Ingelheim, Pfizer, AstraZeneca, Chiesi, Esteve, GlaxoSmithKline, Menarini, Grifols, and Novartis, and consulting fees from Almirall, Boehringer Ingelheim, Pfizer, GlaxoSmithKline, Gebro Pharma, CLS Behring, MedImmune, Takeda, Novartis, and Grifols.

Juan Luis Garcia-Rivero has received speaker fees from Almirall, Boehringer Ingelheim, Pfizer, AstraZeneca, Chiesi, GlaxoSmithKline, Menarini, Takeda, Teva, Ferrer, and Novartis, and consulting fees from Almirall, Boehringer Ingelheim and Menarini. Salud Santos has received speaker fees from Almirall, Boehringer Ingelheim, Pfizer, GlaxoSmithKline, Menarini, Novartis, and Teva Pharma, and consulting fees from Almirall, Gebro Pharma, Novartis, Faes, and Menarini.

Jéssica Montero-Caballero, Frank Richard, and Xavier Ribera are employees of Boehringer Ingelheim. The authors report no other conflicts of interest in this work.