title: Comparison of the Diskus inhaler and the Handihaler regarding preference and ease of use.
abstract: Many chronic obstructive pulmonary disease (COPD) patients use their inhaler ineffectively and there is a trend towards increased inhaler resistance. We wanted to answer two questions: Is there a difference in preference and ease of use between Diskus (DK) and Handihaler (HH)? How acceptable are inhalation resistances? Sixty COPD patients, naive to DK and HH, but experienced in the use of other inhalers, had to read the instruction leaflet and demonstrate their inhalation technique. If errors were made, instruction was given and inhalation technique was checked again. Patients had to state a preference for DK or HH. Subsequently they inhaled through a range of resistances and scored the acceptability. There was no difference in the number of instructions needed for both inhalers. One third inhaled perfectly after reading the instruction leaflet, which increased to 85% after one instruction. More patients preferred the DK (43) than the HH (16). With decreasing resistance acceptability increases, but it reaches a plateau. Patients have a clear preference for the DK. There is no difference in the number of instructions needed to obtain a perfect inhalation technique, but for some patients one instruction is not enough. The trend to increase the resistance of inhalers has reached a critical point with regard to acceptability.
authors: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands. vdpalen@euronet.nl
authors: Job
authors: J
authors: Van Der Palen
authors: Michiel M
authors: MM
authors: Eijsvogel
authors: Bart F
authors: BF
authors: Kuipers
authors: Maria
authors: M
authors: Schipper
authors: Niek A
authors: NA
authors: Vermue
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage; D032882:Comprehension; D004348:Drug Labeling; D004867:Equipment Design; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D012212:Rheology
chemical_list: D001993:Bronchodilator Agents