Inhalation device options for the management of chronic obstructive pulmonary disease

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is characterized by chronic respiratory symptoms and airflow limitation, resulting from abnormalities in the airway and/or damage to the alveoli. Primary care physicians manage the healthcare of a large proportion of patients with COPD. In addition to determining the most appropriate medication regimen, which usually includes inhaled bronchodilators with or without inhaled corticosteroids, physicians are charged with optimizing inhalation device selection to facilitate effective drug delivery and patient adherence. The large variety of inhalation devices currently available present numerous challenges for physicians that include: (1) gaining knowledge of and proficiency with operating different device classes; (2) identifying the most appropriate inhalation device for the patient; and (3) providing the necessary education and training for patients on device use. This review provides an overview of the inhalation device types currently available in the United States for delivery of COPD medications, including information on their successful operation and respective advantages and disadvantages, factors to consider in matching a device to an individual patient, the need for device training for patients and physicians, and guidance for improving treatment adherence. Finally, the review will discuss established and novel tools and technology that may aid physicians in improving education and promoting better adherence to therapy.

KEYWORDS:

• Inhaler
• chronic obstructive pulmonary disease
• pressurized metered-dose inhaler
• dry powder inhaler
• soft mist inhaler
• nebulizer
• adherence

Acknowledgments

Under the direction of the authors, medical writing support was provided by Devin S. Gary, PhD, of Scientific Connexions, an Ashfield Company, part of UDG Healthcare plc (Lyndhurst, NJ, USA), and Hannah Burke, BSc, of Core (London, UK) and editorial support was provided by Maryam Vahdat, PGDip, of Core (London, UK), which were funded by AstraZeneca LP (Wilmington, DE, USA), in accordance with Good Publication Practice guidelines.

Declaration of interest

M DePietro, L Millette, I Gilbert, and M Riebe are employees of AstraZeneca. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Funding for medical writing and editorial support was provided by AstraZeneca LP (Wilmington, DE, USA).