A retrospective observational study examined the use of pressurized metered-dose inhalers and dry powder inhalers among patients with asthma and chronic obstructive pulmonary disease in Spain, and found dry powder inhalers (DPIs) were more commonly prescribed overall, but pressurized metered-dose inhalers (pMDIs) were preferred for elderly patients.
The study published in Respiratory Care found a significant proportion of patients used multiple device types, and switching between device types was relatively common. The analysis included 24,102 asthma patients and 12,858 COPD patients on maintenance inhaled therapy. Study findings included 55% of asthma patients and 39% of COPD patients used DPIs, while 26% of both asthma and COPD patients used pMDIs, and 19% of asthma patients and 35% of COPD patients used a combination of DPI and pMDI devices.
Additional findings included that 25% of asthma patients and 21.6% of COPD patients using pMDIs had switched from DPIs in the previous year, and 14.1% of asthma patients and 11.4% of COPD patients using DPIs had switched from pMDIs in the previous year.
Inhalation chamber use increased with disease severity from 13.4% in mild asthma to 90% in very severe asthma, and also increased with age: 22.8% in 18-39 year olds to 70.1% in ≥75 year olds with asthma, and 43.7% in mild, 44.5% in moderate, 50.5% in moderate-severe, 66.7% in severe, and 71.4% in very severe COPD. Treatment Adherence was found to increase with disease severity and age for both device types.
This retrospective study analyzed data from 1.8 million patients across 7 autonomous communities in Spain. Inclusion criteria were adults ≥18 years old for asthma and ≥40 years old for COPD, with an objective diagnosis and maintenance inhaled therapy prescribed in the 3 months prior to December 31, 2019.
The researchers examined demographic characteristics, clinical features, lung function, comorbidities, and medication use patterns. They also analyzed treatment adherence, defined as retrieving ≥80% of prescribed medication from community pharmacies.
The study provided insights into real-world inhaler device usage patterns in Spain. The findings highlighted differences in device usage based on age, disease severity, and other patient characteristics. The data on device switching and multiple device use suggested potential areas for further investigation in inhaler prescribing practices.