title: [The choice of inhalation device: A medical act].
abstract: Inhaled treatments are essential for respiratory diseases management, including COPD and asthma. Optimal control of the disease largely depends on patient's compliance and proper use of these treatments. Different types of ready-to-use inhaler devices are available: metered dose inhaler, dry powder inhaler or soft mist inhaler. Each of these devices presents specific characteristics and constraints that have to be evaluated and taken into account before prescription. In order to optimize adherence and treatment efficacy, the choice of inhaler device should depend on the specific needs, abilities and preferences of each patient and a specific education to treatment should be provided. Inhaled treatments, even containing the same drug, have different technical constraints and are thus not easily interchangeable. Their substitution without prior medical consent and without proper training can lead to errors in taking treatment, treatment failures and increased health care consumption. In France, substitution by the pharmacist is not authorized. While patient education must be carried out in collaboration with all health professionals, it is preferable that the choice of inhaler device remains the responsibility of the physician.
authors.affiliation: UPRES EA 220 & délégation à la recherche clinique et à l'innovation, pôle des maladies respiratoires, faculté de médecine Paris-Ouest, hôpital Foch, 11, rue Guillaume-Lenoir, 92150 Suresnes, France. Electronic address: p.devillier@hopital-foch.org.
authors.forename: P
authors.initials: P
authors.lastname: Devillier
authors.affiliation: UPRES EA 220 & délégation à la recherche clinique et à l'innovation, pôle des maladies respiratoires, faculté de médecine Paris-Ouest, hôpital Foch, 11, rue Guillaume-Lenoir, 92150 Suresnes, France.
authors.forename: H
authors.initials: H
authors.lastname: Salvator
authors.affiliation: Service de pneumologie et soins intensifs respiratoires, groupe hospitalier Cochin, université Paris Descartes (EA2511), HIA du Val-de-Grâce, 75005 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Roche
mesh_terms: D000280:Administration, Inhalation; D001249:Asthma / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002755:Choice Behavior; D058995:Dry Powder Inhalers / Q000706:statistics & numerical data; D004867:Equipment Design; D006801:Humans; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data; D009330:Nebulizers and Vaporizers / Q000145:classification* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D012138:Respiratory Therapy / Q000295:instrumentation* / Q000379:methods; D012140:Respiratory Tract Diseases / Q000188:drug therapy*
chemical_list: D001993:Bronchodilator Agents
keywords: Asthma; Asthme; BPCO; COPD; Dispositif d’inhalation; Equivalence; Inhaler device; Prescription; Équivalence