title: Moving from CFC aerosol to HFA aerosol or dry powder inhalers: what do patients think?
abstract: OBJECTIVE
  Environmentally friendly hydrofluoroalkane (HFA) pressurised metered-dose inhalers are currently being marketed to replace chlorofluorocarbon (CFC)-driven devices. It is uncertain whether these new formulations with different properties are acceptable to patients. Similarly, switching a patient to a dry powder inhaler (DPI) carries the risk of non-acceptance.
  
  
  METHODS
  One hundred patients with obstructive airway disease on regular CFC aerosol inhaler medication underwent a standardised, structured interview. During the interview patients were asked to use a new HFA aerosol inhaler and three DPIs in random order. Patients' notions were recorded.
  
  
  RESULTS
  Most patients (96) agreed to change from their CFC to the HFA inhaler, of those, only 12 did so with some reservation. Properties (taste, user-friendliness, design) of the HFA inhaler were rated favourably. DPIs represented an acceptable alternative to aerosol inhalers. In fact, 57 patients preferred a DPI over the HFA inhaler. Not all powder devices were equally acceptable. Replacing the CFC inhaler with patients' preferred alternative devices resulted in a more than 3-fold increase in costs.
  
  
  CONCLUSIONS
  Concerns about the acceptability of reformulated CFC-free aerosol inhalers are ill founded. However, if given the choice, many patients prefer a DPI over the HFA inhaler. The transition offers an opportunity to review patients' current treatment and the proficiency of their inhaling technique. Moving to CFC-free inhalers will have revenue implications.
authors.affiliation: Respiratory Department, Ninewells Hospital, Dundee, UK. Thomas.Hartung@tuht.scot.nhs.uk
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Hartung
authors.forename: Helen
authors.initials: H
authors.lastname: Allbutt
authors.forename: Maria
authors.initials: M
authors.lastname: Dewar
authors.forename: J Alastair
authors.initials: JA
authors.lastname: Innes
authors.forename: Graham K
authors.initials: GK
authors.lastname: Crompton
mesh_terms: D000293:Adolescent; D000328:Adult; D000335:Aerosol Propellants; D000368:Aged; D000369:Aged, 80 and over; D017402:Chlorofluorocarbons; D004867:Equipment Design; D005260:Female; D006801:Humans; D006845:Hydrocarbons, Fluorinated; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D017060:Patient Satisfaction
chemical_list: D000335:Aerosol Propellants; D017402:Chlorofluorocarbons; D006845:Hydrocarbons, Fluorinated