title: Identifying the features of an easy-to-use and intuitive dry powder inhaler for asthma and chronic obstructive pulmonary disease therapy: results from a 28-day device handling study, and an airflow resistance study.
abstract: BACKGROUND
  Many patients with asthma and chronic obstructive pulmonary disease (COPD) symptoms remain insufficiently controlled despite inhalation treatment, with poor inhaler technique recognized as a significant contributor. Dry powder inhalers (DPIs) need less coordination of actuation and inspiration than pressured metered dose inhalers.
  
  
  OBJECTIVE
  To assess whether consideration of 'ideal inhaler' features during design and development of a new DPI device (Forspiro® Sandoz AG, Switzerland) led to an easy-to-use and reliable inhaler.
  
  
  METHODS
  Two studies are reported here: i) 24 adult Accuhaler® users received either limited written instructions (n = 12) or fully illustrated instructions (n = 12) for the Forspiro device; and ii) peak inspiratory flow rates through the Forspiro device were assessed in 30 adult and 10 pediatric patients with asthma and 10 adult patients with COPD.
  
  
  RESULTS
  All subjects understood the correct sequence of actions for the Forspiro device and rated all aspects of handling the device as 'very easy' or 'fairly easy' (except one uninstructed subject who rated 'ease of determining number of doses left' as 'fairly difficult'). All patients achieved ≥ 35 l/min, thus demonstrating that the Forspiro device provides low-medium airflow resistance.
  
  
  CONCLUSIONS
  Inhaler design providing good drug delivery with maximum ease of use may lead to more reliable therapy and improved control of airway diseases.
authors.affiliation: University Clinic Rostock, Zentrum f. Innere Medizin, Department of Pulmonology, Intensive Care Medicine, Klinik I , Rostock , Germany jc.h.virchow@sunrise.ch.
authors.forename: J Christian
authors.initials: JC
authors.lastname: Virchow
authors.forename: Thomas
authors.initials: T
authors.lastname: Weuthen
authors.forename: Quentin J
authors.initials: QJ
authors.lastname: Harmer
authors.forename: Spencer
authors.initials: S
authors.lastname: Jones
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation; D058995:Dry Powder Inhalers / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012646:Self Administration / Q000295:instrumentation; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: asthma; chronic obstructive pulmonary disease; device handling study; dry powder inhaler; ease of use; salbutamol