Real-life association between inhaler technique, patient preference and asthma control in patients with uncontrolled asthma switched to budesonide/formoterol DuoResp (R) Spiromax (R) combination

摘要

Objective: In asthma, treatment effectiveness is strongly influenced by the quality of inhaler use. New devices such as Spiromax (R) have been specifically developed to improve ease of use. It is crucial to determine whether switching to such a device improves inhaler technique and clinical outcomes, and to identify factors associated with handling errors. Methods: This observational study assessed inhaler device handling errors in 1435 asthma patients recruited via 135 participating physicians in France, before and after switching therapy from the Symbicort Turbuhaler (R) or Seretide (R) Diskus (R) to DuoResp (R) Spiromax (R). Patients received training in the use of their new device at baseline and were re-assessed after three months. Results: After three months of use, 67 of patients were using the DuoResp (R) Spiromax (R) with no handling errors, and 88 with no critical errors. The presence of comorbidities was associated with handling errors overall. Concurrent illness potentially affecting device handling and previous training were associated with critical device handling errors. Most patients (85.4) preferred DuoResp (R) Spiromax (R) over their previous device. Levels of inadequately controlled or uncontrolled asthma were reduced from baseline among patients using DuoResp (R) Spiromax (R) (8.6 versus 64.6), and were higher in patients with critical handling errors. Conclusions: Effective patient education, correct inhaler technique, treatment adherence and devices associated with high patient satisfaction are interrelated factors key to the successful delivery of inhaled asthma therapy. Inhaler technique and patient device satisfaction should be routinely assessed in treated patients with uncontrolled asthma.