Identificador para citar o enlazar este ítem: https://hdl.handle.net/20.500.13003/18773
Clinical recommendations for dry powder inhaler use in the management of COPD in primary care
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eISSN: 2055-1010
WOS ID: 000905054800001
Scopus EID: 2-s2.0-85144793230
PMID: 36575175
Embase PUI: L2020855204
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Leving, Marika T; Bosnic-Anticevich, Sinthia; van Cooten, Joyce; Correia de Sousa, Jaime; Cvetkovski, Biljana; Dekhuijzen, Richard; Dijk, Lars; Pardo, Marina Garcia; Gardev, Asparuh; Gawlik, Radosław; van der Ham, Iris; Janse, Ymke; Lavorini, Federico; Maricoto, Tiago; Meijer, Jiska; Metz, Boyd; Price, David; Roman-Rodriguez, Miguel; Schuttel, Kirsten; Stoker, Nilouq; Tsiligianni, Ioanna; Usmani, Omar; Emerson-Stadler, Rachel; Kocks, Janwillem W HFecha de publicación
2022-12-27Tipo de documento
research articleCitación
Leving MT, Bosnic-Anticevich S, van Cooten J, de Sousa JC, Cvetkovski B, Dekhuijzen R, et al. Clinical recommendations for dry powder inhaler use in the management of COPD in primary care. npj Prim Care Respir Med. 2022 Dec 27;32(1):59.Resumen
Over 1400 patients using dry powder inhalers (DPIs) to deliver COPD maintenance therapies were recruited across Europe and Australia. Their peak inspiratory flow (PIF) was measured, inhaler technique was observed, and adherence to treatment assessed. From relating the findings with patient health status, and thereby identifying critical errors, key clinical recommendations for primary care clinicians were determined, namely - measure PIF before prescribing a DPI to ensure inhalation manoeuvre ability is well-matched with the device. Some patients could benefit from inhalation training whereas others should have their DPI changed for one better suited to their inspiratory ability or alternatively be prescribed an active device (such as a soft mist inhaler or pressurized metered dose inhaler). Observing the inhalation technique was valuable however this misses suboptimal PIF (approaching one fourth of patients with a satisfactory observed manoeuvre had a suboptimal PIF for their DPI). Assess adherence as deliberate non-adherence can point to a mismatch between a patient and their inhaler (deliberate non-adherence was significantly associated with PIFs below the minimum for the DPI). In-person observation of inhalation technique was found to be inferior to video rating based on device-specific checklists. Where video assessments are not possible, observation training for healthcare professionals would therefore be valuable particularly to improve the ability to identify the critical errors associated with health status namely 'teeth and lips sealed around mouthpiece', 'breathe in' and 'breathing out calmly after inhalation'. However, it is recommended that observation alone should not replace PIF measurement in the DPI selection process.Trial registration: https://clinicaltrials.gov/ct2/show/NCT04532853 .
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https://doi.org/10.1038/s41533-022-00318-3MeSH
Dry Powder InhalersAdministration, Inhalation
Pulmonary Disease, Chronic Obstructive
Humans
Primary Health Care
Metered Dose Inhalers
DeCS
Enfermedad Pulmonar Obstructiva CrónicaHumanos
Inhaladores de Dosis Medida
Atención Primaria de Salud
Administración por Inhalación
Inhaladores de Polvo Seco
Colecciones de Docusalut en las que aparece este ítem
Atención Primaria de Mallorca - APMALL > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica