Simulated-use study of inhaler usability in patients with COPD

Introduction: Data on performance of tasks required for correct handling of soft mist inhalers (SMIs) or pressurized metered dose inhalers (pMDIs) in COPD patients experienced with, but not recently trained in, use of such devices are limited. Aims and Objectives: To assess handling/usability of a SMI and a pMDI Methods: Simulated-use, parallel-group study (D5970R0004) in 61 COPD patients (52% male, 40–78 years; diagnosis ≥6 months) with current or past experience using SMIs (n=17) or pMDIs (n=54). Patients were given a device together with the instruction-for-use leaflet but no training, and were observed and video recorded while performing tasks required for priming and dosing. Active devices were actuated into a fume hood. Errors were categorised as critical or non-critical, based on whether they could substantially affect the lung delivered dose (Molimard Eur Respir J 2016;48:PA4078). Results: 31 patients were given a SMI and 30 a pMDI. Overall, 82% (50/61) made ≥5 task performance errors (SMI 94%; pMDI 70%); 49% (30/61) made ≥5 critical errors (SMI 68%; pMDI 30%) (Table). All patients made ≥1 error, only 3 (all pMDI) made no critical errors. Conclusion: Critical errors were more common with a SMI than a pMDI. However, overall task performance with both devices was poor in inhaler-experienced patients, resulting in handling and critical errors. Regardless of device, education and retraining during follow-up are key aspects of patient care in COPD.