title: Real-world assessment of a metered-dose inhaler with integrated dose counter.
abstract: Currently available metered dose inhalers (MDIs) do not track the remaining number of doses, indicating the need for a device that accurately monitors medication use. In an open-label study at 37 outpatient centers, patients > or =4 years old with asthma or chronic obstructive pulmonary disease requiring short-acting 32-agonists received two actuations of albuterol hydrofluoroalkane (HFA) [Ventolin HFA: GlaxoSmithKline], 90 microg twice daily, via a novel MDI with an integrated dose counter until all 200 actuations were completed. Concordance between counter readings, diary card-recorded actuations, and canister weights were measured in patients who completed > or =90% of the labeled actuations (n = 224). Adverse events and patient satisfaction were assessed in the intent-to-treat population (n = 268). In 43,865 recorded actuations, 333 counter versus diary discrepancies occurred (discrepancy rate of 0.76%), and 88% of discrepancies were by one to two actuations. Forty-seven percent of patients had no discrepancies. Incidence of the device firing without changes in counter readings was very low (0.09%). Mean expected actuations based on canister weights (184) were slightly lower than mean counter and diary-reported actuations (200 each). At baseline, 62% of patients reported anxiety about not knowing the quantity of medication remaining in their inhaler. On study completion, 92% expressed satisfaction with the dose counter and 92% agreed it would help prevent them from running out of medication. The adverse event profile showed that albuterol HFA was well tolerated. Integrated MDI counters are a useful and reliable tool for tracking a patient's medication supply.
authors.affiliation: Pediatric Allergy/Immunology Associates, PA, Dallas, Texas, USA. richw3@swbell.net
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wasserman
authors.forename: Ketan
authors.initials: K
authors.lastname: Sheth
authors.forename: William R
authors.initials: WR
authors.lastname: Lincourt
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Locantore
authors.forename: Jacqueline Carranza
authors.initials: JC
authors.lastname: Rosenzweig
authors.forename: Courtney
authors.initials: C
authors.lastname: Crim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers; D008875:Middle Aged; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol