title: Domiciliary experience of the Target Inhalation Mode (TIM) breathing maneuver in patients with cystic fibrosis.
abstract: BACKGROUND
  The time requirements for multiple daily nebulizer treatments are important impediments to the quality of life for most patients with cystic fibrosis (CF). The I-neb Adaptive Aerosol Delivery (AAD) System can be used with a new mode of breathing during inhalation of aerosol, the Target Inhalation Mode (TIM). As a function of the TIM algorithm, the patient is guided to a slow and deep inhalation, which can result in shorter treatment times.
  
  
  METHODS
  This study was conducted as a 3-month patient handling study of the I-neb AAD System in 42 patients with CF aged 12-57 years. The I-neb AAD System was supplied in both the standard Tidal Breathing Mode (TBM), and in TIM. Patients were trained to use the I-neb AAD System in TIM for the delivery of all their inhaled medications, but if they were not comfortable with the TIM maneuver they could change to the TBM maneuver. The primary variables were compliance with the correct use of the I-neb AAD System, and treatment times. The secondary variables were based on study questionnaires at the end of the study and covered ease of use, patient confidence, and patient satisfaction with the I-neb AAD System.
  
  
  RESULTS
  There were a total of 10,240 complete treatments and of these, 8979 (88%) were in TIM. Compliance with the correct use of the I-neb AAD System was 97.6%. The mean treatment time for complete treatments in TIM was 4.20 min, compared with 6.83 min when using the I-neb AAD System in TBM. The responses to the questionnaires indicated that over 77% of the patients found the I-neb AAD System in TIM to be either: very easy, easy, or acceptable to use.
  
  
  CONCLUSIONS
  The results demonstrated that by using the I-neb AAD System in TIM, a 40-50% reduction of nebulizer treatment times, and a high level of compliance could be achieved. The results also showed that the patients found the I-neb AAD System easy to use.
authors.affiliation: Philips Respironics, Respiratory Drug Delivery Ltd, Chichester, United Kingdom. john.denyer@philips.com <john.denyer@philips.com>
authors.forename: John
authors.initials: J
authors.lastname: Denyer
authors.forename: Alex
authors.initials: A
authors.lastname: Black
authors.forename: Kurt
authors.initials: K
authors.lastname: Nikander
authors.forename: Tony
authors.initials: T
authors.lastname: Dyche
authors.forename: Ivan
authors.initials: I
authors.lastname: Prince
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy; D016503:Drug Delivery Systems / Q000295:instrumentation*; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D015656:Respiratory Mechanics; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations