title: Preference, satisfaction and errors with two dry powder inhalers in patients with COPD.
abstract: OBJECTIVE
  To assess preference, satisfaction and critical errors with a novel, breath-actuated, multi-dose dry powder inhaler (DPI; Genuair®/Pressair™), versus a widely used, single-dose DPI (HandiHaler®) in patients with moderate-to-severe chronic obstructive pulmonary disease.
  
  
  METHODS
  In this randomised, open-label, multicentre, cross-over study, patients (aged ≥ 40 years) inhaled placebo once daily through both inhalers for 2 weeks in addition to current medication. The primary end point was percentage of patients who preferred Genuair to HandiHaler. Overall patient satisfaction (5-point scale: 1 = very dissatisfied; 5 = very satisfied), critical errors and willingness to continue using each inhaler (0 = not willing; 100 = definitely willing) were assessed.
  
  
  RESULTS
  Of 130 patients randomised, 105 were included in the intent-to-treat population (71.4% male; mean age 65.7 years). After 2 weeks, significantly more patients preferred Genuair than HandiHaler (79.1 vs 20.9%; p < 0.0001). Overall satisfaction scores (4.6 vs 3.8; p < 0.0001) and willingness to continue use scores (84.0 vs 62.5; p < 0.0001) were significantly higher with Genuair versus HandiHaler. Significantly fewer patients made ≥ 1 critical error with Genuair only compared with HandiHaler only (2.9 vs 19.0%; p < 0.0001).
  
  
  CONCLUSIONS
  After 2 weeks' practice, patients preferred and were more willing to continue using Genuair than HandiHaler. Genuair was associated with higher patient satisfaction and fewer critical errors than HandiHaler.
authors.affiliation: University of Twente, Department of Research Methodology, Measurement and Data Analysis, Enschede, The Netherlands. j.vanderpalen@mst.nl
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.forename: Thomas
authors.initials: T
authors.lastname: Ginko
authors.forename: Axel
authors.initials: A
authors.lastname: Kroker
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Martijn
authors.initials: M
authors.lastname: Goosens
authors.forename: Laura
authors.initials: L
authors.lastname: Padullés
authors.forename: Beatriz
authors.initials: B
authors.lastname: Seoane
authors.forename: Ludmyla
authors.initials: L
authors.lastname: Rekeda
authors.forename: Esther
authors.initials: E
authors.lastname: Garcia Gil
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D058995:Dry Powder Inhalers / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D001993:Bronchodilator Agents