The study aimed to determine the associations of Peak Inspiratory Flow (PIF), inhalation technique and adherence with health status and exacerbations in participants with COPD using DPI maintenance therapy. This cross-sectional multi-country observational real-world study included COPD participants aged ≥40 years using a DPI for maintenance therapy. PIF was measured three times with the In-Check DIAL G16: (1) typical PIF at resistance of participant's inhaler, (2) maximal PIF at resistance of participant's inhaler, (3) maximal PIF at low resistance. Suboptimal PIF (sPIF) was defined as PIF lower than required for the device. Participants completed questionnaires on health status (Clinical COPD Questionnaire (CCQ)), adherence (Test of Adherence to Inhalers (TAI)) and exacerbations. Inhalation technique was assessed by standardised evaluation of video recordings. Complete data were available from 1434 participants (50.1% female, mean age 69.2 years). GOLD stage was available for 801 participants: GOLD stage I (23.6%), II (54.9%), III (17.4%) and IV (4.1%)). Of all participants, 29% had a sPIF, and 16% were shown able to generate an optimal PIF but failed to do so. sPIF was significantly associated with worse health status (0.226 (95% CI 0.107-0.346), worse units on CCQ; p = 0.001). The errors 'teeth and lips sealed around mouthpiece', 'breathe in', and 'breathe out calmly after inhalation' were related to health status. Adherence was not associated with health status. After correcting for multiple testing, no significant association was found with moderate or severe exacerbations in the last 12 months. To conclude, sPIF is associated with poorer health status. This study demonstrates the importance of PIF assessment in DPI inhalation therapy. Healthcare professionals should consider selecting appropriate inhalers in cases of sPIF.

Factors associated with health status and exacerbations in COPD maintenance therapy with dry powder inhalers / W H Kocks, Janwillem; Wouters, Hans; Bosnic-Anticevich, Sinthia; van Cooten, Joyce; Correia de Sousa, Jaime; Cvetkovski, Biljana; Dekhuijzen, Richard; Dijk, Lars; Dvortsin, Evgeni; Garcia Pardo, Marina; Gardev, Asparuh; Gawlik, Radosław; van Geer-Postmus, Iris; van der Ham, Iris; Harbers, Marten; de la Hoz, Alberto; Janse, Ymke; Kerkhof, Marjan; Lavorini, Federico; Maricoto, Tiago; Meijer, Jiska; Metz, Boyd; Price, David; Roman-Rodriguez, Miguel; Schuttel, Kirsten; Stoker, Nilouq; Tsiligianni, Ioanna; Usmani, Omar; Leving, Marika T. - In: NPJ PRIMARY CARE RESPIRATORY MEDICINE. - ISSN 2055-1010. - ELETTRONICO. - 32:(2022), pp. 0-0. [10.1038/s41533-022-00282-y]

Factors associated with health status and exacerbations in COPD maintenance therapy with dry powder inhalers

Lavorini, Federico
Membro del Collaboration Group
;
2022

Abstract

The study aimed to determine the associations of Peak Inspiratory Flow (PIF), inhalation technique and adherence with health status and exacerbations in participants with COPD using DPI maintenance therapy. This cross-sectional multi-country observational real-world study included COPD participants aged ≥40 years using a DPI for maintenance therapy. PIF was measured three times with the In-Check DIAL G16: (1) typical PIF at resistance of participant's inhaler, (2) maximal PIF at resistance of participant's inhaler, (3) maximal PIF at low resistance. Suboptimal PIF (sPIF) was defined as PIF lower than required for the device. Participants completed questionnaires on health status (Clinical COPD Questionnaire (CCQ)), adherence (Test of Adherence to Inhalers (TAI)) and exacerbations. Inhalation technique was assessed by standardised evaluation of video recordings. Complete data were available from 1434 participants (50.1% female, mean age 69.2 years). GOLD stage was available for 801 participants: GOLD stage I (23.6%), II (54.9%), III (17.4%) and IV (4.1%)). Of all participants, 29% had a sPIF, and 16% were shown able to generate an optimal PIF but failed to do so. sPIF was significantly associated with worse health status (0.226 (95% CI 0.107-0.346), worse units on CCQ; p = 0.001). The errors 'teeth and lips sealed around mouthpiece', 'breathe in', and 'breathe out calmly after inhalation' were related to health status. Adherence was not associated with health status. After correcting for multiple testing, no significant association was found with moderate or severe exacerbations in the last 12 months. To conclude, sPIF is associated with poorer health status. This study demonstrates the importance of PIF assessment in DPI inhalation therapy. Healthcare professionals should consider selecting appropriate inhalers in cases of sPIF.
32
0
0
Goal 3: Good health and well-being
W H Kocks, Janwillem; Wouters, Hans; Bosnic-Anticevich, Sinthia; van Cooten, Joyce; Correia de Sousa, Jaime; Cvetkovski, Biljana; Dekhuijzen, Richard; Dijk, Lars; Dvortsin, Evgeni; Garcia Pardo, Marina; Gardev, Asparuh; Gawlik, Radosław; van Geer-Postmus, Iris; van der Ham, Iris; Harbers, Marten; de la Hoz, Alberto; Janse, Ymke; Kerkhof, Marjan; Lavorini, Federico; Maricoto, Tiago; Meijer, Jiska; Metz, Boyd; Price, David; Roman-Rodriguez, Miguel; Schuttel, Kirsten; Stoker, Nilouq; Tsiligianni, Ioanna; Usmani, Omar; Leving, Marika T
File in questo prodotto:
File Dimensione Formato  
41533_2022_Article_282.pdf

accesso aperto

Tipologia: Pdf editoriale (Version of record)
Licenza: Open Access
Dimensione 1.72 MB
Formato Adobe PDF
1.72 MB Adobe PDF Visualizza/Apri

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2158/1287011
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 1
  • ???jsp.display-item.citation.isi??? ND
social impact