Which factors affect the choice of the inhaler in chronic obstructive respiratory diseases?
Inhalation is the preferred route of drug administration in chronic respiratory diseases because it optimises delivery of the active compounds to the targeted site and minimises side effects from systemic distribution. The choice of a device should be made after careful evaluation of the patient's clinical condition (degree of airway obstruction, comorbidities), as well as their ability to coordinate the inhalation manoeuvre and to generate sufficient inspiratory flow. These patient factors must be aligned with the specific advantages and limitations of each inhaler when making this important choice. Finally, adherence to treatment is not the responsibility of the patient alone, but should be shared also by clinicians. Clinicians have access to a wide selection of pressurised metered dose inhalers (pMDIs) and dry powder inhalers (DPIs) that can be used effectively when matched to the needs of individual patients; this should be perceived as an opportunity rather than a limitation.
Dipartimento di Biomedicina e Medicina Specialistica (DIBIMIS), Sezione di Pneumologia, University of Palermo, Italy. Electronic address: nicola.scichilone@unipa.it.
Nicola
N
Scichilone
Dipartimento di Biomedicina e Medicina Specialistica (DIBIMIS), Sezione di Pneumologia, University of Palermo, Italy.
Alida
A
Benfante
Università degli Studi di Napoli "Federico II", Dipartimento di medicina clinica e chirurgia, Napoli, Italy.
Marialuisa
M
Bocchino
Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCS AOU San Martino-IST, Genoa, Italy.
Fulvio
F
Braido
Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy.
Pierluigi
P
Paggiaro
Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Alberto
A
Papi
Dipartimento di Scienze della Salute, Pneumologia Riabilitativa Fondazione Salvatore Maugeri, Istituto Scientifico di Milano-IRCCS, Università degli Studi di Milano, Italy.
Pierachille
P
Santus
Università degli Studi di Napoli "Federico II", Dipartimento di medicina clinica e chirurgia, Napoli, Italy.
Alessandro
A
Sanduzzi
D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use; D058995:Dry Powder Inhalers; D006801:Humans; D055118:Medication Adherence; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers; D010316:Particle Size; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012996:Solutions; D013535:Suspensions
D018927:Anti-Asthmatic Agents; D012996:Solutions; D013535:Suspensions
Adherence; Asthma; COPD; Inhaler