Abstract
Background
Inhalation therapy is the cornerstone of treatment of bronchial asthma. A patient-specific selection of inhalation devices is necessary, as preference for a device plays an important role in terms of error rates in handling and adherence to therapy. However, there is no industry-independent study providing information on children’s preferences for common inhaler types. The aim of the present study was to investigate the preference of asthmatic children for inhaler types commonly used in Germany. The effects of age, gender and the type of school visited on device preferences as well as the frequency of patient education and the role of health care providers in the choice for an inhaler were investigated.
Methods
Eighty children were included in this prospective cross-sectional study (age: 10.87 ± 2.62 years). The analysis was based on a questionnaire and validated checklists. All participants tested the use of nine placebo inhalers (Breezhaler, Diskus, Respimat, Spiromax, Turbohaler, Autohaler, metered-dose inhaler, Easyhaler and Novolizer) in a randomized order. For each device, patients were asked to assess handling, rate different device characteristics and name the device they would prefer most or least.
Results
The most favored device was the Novolizer. Moreover, the Spiromax scored highest in numerous categories such as suitability in emergencies and “easiest” device to use. Patient preferences with respect to the addressed inhaler features were not significantly related to age, gender or school type.
Conclusion
The Novolizer and the Spiromax showed higher preference in pediatric patients as compared to other tested devices. Overall, there were significant differences in terms of preference when comparing the tested inhalers in different aspects.
Data Sharing Statement
The datasets used and/or analysed during the study are available from the corresponding author on reasonable request.
Ethics Approval and Consent to Participate
Written informed consent was obtained from each participant and their parents, as all patients were under 18 years of age. The study complies with the Declaration of Helsinki and the study protocol was approved by the local ethics committee of Otto von Guericke University Magdeburg, Germany. Reference number: 75/17.
Aknowledgment
We thank all the children and parents who made a great contribution and made the work so special. Furthermore, we would like to thank all staff members of the asthma outpatient clinic of the Department of Pediatrics and the Department of Pneumology of the University Medicine Magdeburg. In particular, we thank Dr. rer. nat. Sabine Stegemann-Koniszewski and Dr. med. Annett Lambrecht as well as Dipl.-Phys., M.Sc. Dirk Schomburg from the Institute of Biometry and Medical Informatics (IBMI).
Author Contributions
All authors have made significant contributions to the report, whether in its conception, design, execution, analysis, interpretation, or all of the above; have participated in the drafting, revision, or critical review of the article; have given final approval for the version to be published; have agreed on the journal to which the article was submitted; and agree to be responsible for all aspects of the work.
Disclosure
The authors declare that they have no competing interests.