title: Respimat Soft Mist inhaler versus hydrofluoroalkane metered dose inhaler: patient preference and satisfaction.
abstract: BACKGROUND
  In addition to offering favorable pharmaceutical performance, an ideal inhaler should be well accepted by patients, as this may facilitate compliance. We report a study that specifically assessed inhaler preference in patients with obstructive lung disease after treatment with ipratropium bromide/fenoterol hydrobromide (Berodual delivered via either Respimat Soft Mist Inhaler (SMI) or hydrofluoroalkane metered dose inhaler (HFA-MDI).
  
  
  METHODS
  Patients with COPD, asthma or mixed disease were randomized to receive ipratropium bromide/fenoterol hydrobromide 20/50 microg via Respimat SMI or 40/100 microg via HFA-MDI for 7 weeks each, in a crossover design. Patients were trained in inhaler use and given < or =5 attempts to demonstrate satisfactory technique. At the end of each treatment period, patients completed a 15-item satisfaction questionnaire, and inhaler technique was re-tested. On study completion, patients were asked which inhaler they preferred and they rated their willingness to continue using each inhaler. Clinical efficacy outcomes were measured by diary card to check whether switching inhaler affected efficacy.
  
  
  RESULTS
  In total, 245 patients were randomized and 224 used both inhalers within their respective treatment periods. Of 201 patients expressing a preference, 162 (81%) preferred Respimat SMI and 39 (19%) preferred HFA-MDI (p < 0.001). Patients would rather continue using Respimat SMI than HFA-MDI (p < 0.001). Mean scores for 13 of the 15 satisfaction questions were significantly higher for Respimat SMI than HFA-MDI (p < 0.05); in addition, the total score was also significantly higher for Respimat SMI (p < 0.001). Most patients (217/224; 97%) were judged to have good technique with Respimat SMI after 7 weeks' use. Differences in efficacy measures between the devices were not significant.
  
  
  CONCLUSIONS
  These data indicated that a large majority of patients preferred Respimat SMI to HFA-MDI.
authors.affiliation: Pneumologische Praxis, Marburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schürmann
authors.forename: Sören
authors.initials: S
authors.lastname: Schmidtmann
authors.forename: Petra
authors.initials: P
authors.lastname: Moroni
authors.forename: Dan
authors.initials: D
authors.lastname: Massey
authors.forename: Mahmud
authors.initials: M
authors.lastname: Qidan
mesh_terms: D000336:Aerosols; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004338:Drug Combinations; D005260:Female; D005280:Fenoterol / Q000627:therapeutic use*; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000627:therapeutic use*; D009241:Ipratropium / Q000627:therapeutic use*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D004338:Drug Combinations; D006845:Hydrocarbons, Fluorinated; C030809:fenoterol, ipratropium drug combination; D005280:Fenoterol; D009241:Ipratropium