Original Articles
Patient Preference in the Choice of Dry Powder Inhalers
J. Giner
, M. Torrejón, A. Ramos, P. Casan, C. Granel, V. Plaza, J. Belda, J. Sanchis
Corresponding author
jginer@hsp.santpau
Correspondence: Dr. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i de Sant Pau. Antoni Maria Claret, 167. 08025 Barcelona. España
Correspondence: Dr. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i de Sant Pau. Antoni Maria Claret, 167. 08025 Barcelona. España
Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sanchis" "autores" => array:8 [ 0 => array:5 [ "preGrado" => "Dr" "nombre" => "J." "apellidos" => "Giner" "email" => array:1 [ 0 => "jginer@hsp.santpau" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Torrejón" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Ramos" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Casan" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Granel" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Plaza" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Belda" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Sanchis" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i de Sant Pau. Antoni Maria Claret, 167. 08025 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-03-17" "fechaAceptado" => "2003-10-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153303" "palabras" => array:3 [ 0 => "Asthma" 1 => "Dry powder inhalers" 2 => "Preferences" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153304" "palabras" => array:3 [ 0 => "Asma" 1 => "Inhaladores en polvo" 2 => "Preferencias" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To investigate a group of patients' preferences among 3 dry powder inhalers—Accuhaler®, Easyhaler®, and Turbuhaler®—and to analyze the features that were most important for motivating choices.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p class="elsevierStyleSimplePara elsevierViewall">The study enrolled 30 patients with stable asthma with a mean (SD) age of 40 (13) and who habitually used inhaled corticosteroids. The patients were shown in detail how to use each of the devices and were randomized to begin using them in different orders. After using each inhaler for a week, the patients assessed 9 different features on a scale of 0 to 10 with an independent observer. The patients were asked to put the inhalers in order of preference, and finally to demonstrate they could use them correctly.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">All patients correctly performed the inhalation maneuver at the beginning and the end of the study. The mean final scores out of 90 of the 9 features evaluated were 75 (13) for the Easyhaler, 67 (12) for the Accuhaler, and 65 (14) for the Turbuhaler. Differences were statistically significant between the first and the second device (<span class="elsevierStyleItalic">P</span>=0.02) and the first and the third (<span class="elsevierStyleItalic">P</span>=.001) but not between the Accuhaler and the Turbuhaler (<span class="elsevierStyleItalic">P</span>=.376). Mean rating scores were 8.6 (1.4) for the Easyhaler, 7.3 (1.9) for the Turbuhaler, and 7.1 (1.6) for the Accuhaler. The Easyhaler was the first choice for 53% of patients, the Turbuhaler for 27%, and the Accuhaler for 20%.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The Easyhaler was rated the highest by the patients in the study. The scores were a long way from the maximum score, so research into developing an ideal inhaler must continue.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer las preferencias de un grupo de pacientes acerca de 3 dispositivos de inhalación en polvo –Accuhaler®, Easyhaler® y Turbuhaler® – y analizar los aspectos más importantes que motivan su elección.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió a 30 pacientes de 40 ± 13 años, asmáticos y estables, que se administraban habitualmente corticoides inhalados. Se les explicó detalladamente la técnica de utilización de cada uno de los dispositivos y, de forma aleatoria, se asignó el orden en que debían utilizarlos. Tras una semana de usar cada uno de los dispositivos, un observador independiente evaluó 9 aspectos distintos de los dispositivos, valorados de 0 a 10 puntos. Se pidió a los pacientes que determinaran el orden de preferencia y finalmente se evaluó la técnica de utilización.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes realizaron correctamente la técnica de inhalación, al principio y al final del estudio. Las puntuaciones totales de los 9 aspectos evaluados, sobre 90 puntos, fueron de 75 ± 13 puntos para Easyhaler, de 67 ± 12 para Accuhaler y de 65 ± 14 para Turbuhaler. Las diferencias fueron estadísticamente significativas entre el primero y el segundo (p = 0,02) y entre el primero y el tercero (p = 0,001), pero no para Accuhaler y Turbuhaler (p = 0,376). Las medias de los valores fueron de 8,6 ± 1,4 para Easyhaler, de 7,3 ± 1,9 para Turbuhaler y de 7,1 ± 1,6 para Accuhaler. El 53% de los pacientes escogió el dispositivo Easyhaler, el 27% el Turbuhaler y el 20% el Accuhaler.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">El dispositivo Easyhaler fue el mejor valorado por los pacientes evaluados. Las puntuaciones obtenidas para cada dispositivo distan de la puntuación máxima, por lo que deberá continuar investigándose para obtener el inhalador ideal.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adherence with twice-daily dosing of inhaled steroids. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 5 | 9 |
| 2024 October | 29 | 20 | 49 |
| 2024 September | 29 | 14 | 43 |
| 2024 August | 53 | 32 | 85 |
| 2024 July | 42 | 25 | 67 |
| 2024 June | 38 | 20 | 58 |
| 2024 May | 50 | 25 | 75 |
| 2024 April | 20 | 19 | 39 |
| 2024 March | 26 | 12 | 38 |
| 2024 February | 30 | 14 | 44 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 23 | 18 | 41 |
| 2023 January | 32 | 22 | 54 |
| 2022 December | 33 | 30 | 63 |
| 2022 November | 34 | 21 | 55 |
| 2022 October | 34 | 74 | 108 |
| 2022 September | 20 | 25 | 45 |
| 2022 August | 26 | 37 | 63 |
| 2022 July | 24 | 30 | 54 |
| 2022 June | 14 | 26 | 40 |
| 2022 May | 19 | 32 | 51 |
| 2022 April | 24 | 23 | 47 |
| 2022 March | 19 | 39 | 58 |
| 2022 February | 18 | 28 | 46 |
| 2022 January | 20 | 33 | 53 |
| 2021 December | 19 | 44 | 63 |
| 2021 November | 24 | 55 | 79 |
| 2021 October | 17 | 32 | 49 |
| 2021 September | 22 | 45 | 67 |
| 2021 August | 21 | 34 | 55 |
| 2021 July | 16 | 24 | 40 |
| 2021 June | 13 | 37 | 50 |
| 2021 May | 22 | 27 | 49 |
| 2021 April | 74 | 58 | 132 |
| 2021 March | 30 | 19 | 49 |
| 2021 February | 11 | 11 | 22 |
| 2021 January | 12 | 5 | 17 |
| 2020 December | 11 | 24 | 35 |
| 2020 November | 7 | 11 | 18 |
| 2020 October | 10 | 11 | 21 |
| 2020 September | 8 | 8 | 16 |
| 2020 August | 13 | 13 | 26 |
| 2020 July | 14 | 22 | 36 |
| 2020 June | 6 | 3 | 9 |
| 2020 May | 20 | 21 | 41 |
| 2020 April | 13 | 12 | 25 |
| 2020 March | 9 | 14 | 23 |
| 2020 February | 9 | 13 | 22 |
| 2020 January | 20 | 12 | 32 |
| 2019 December | 15 | 17 | 32 |
| 2019 November | 6 | 9 | 15 |
| 2019 October | 9 | 12 | 21 |
| 2019 September | 6 | 16 | 22 |
| 2019 August | 13 | 13 | 26 |
| 2019 July | 7 | 19 | 26 |
| 2019 June | 7 | 19 | 26 |
| 2019 May | 17 | 30 | 47 |
| 2019 April | 39 | 23 | 62 |
| 2019 March | 21 | 23 | 44 |
| 2019 February | 6 | 13 | 19 |
| 2019 January | 4 | 10 | 14 |
| 2018 December | 6 | 17 | 23 |
| 2018 November | 14 | 15 | 29 |
| 2018 October | 24 | 16 | 40 |
| 2018 September | 10 | 10 | 20 |
| 2018 May | 7 | 1 | 8 |
| 2018 April | 5 | 8 | 13 |
| 2018 March | 3 | 12 | 15 |
| 2018 February | 3 | 10 | 13 |
| 2018 January | 2 | 11 | 13 |
| 2017 December | 6 | 8 | 14 |
| 2017 November | 4 | 4 | 8 |
| 2017 October | 4 | 10 | 14 |
| 2017 September | 9 | 18 | 27 |
| 2017 August | 9 | 22 | 31 |
| 2017 July | 4 | 17 | 21 |
| 2017 June | 8 | 29 | 37 |
| 2017 May | 7 | 27 | 34 |
| 2017 April | 4 | 20 | 24 |
| 2017 March | 8 | 5 | 13 |
| 2017 February | 1 | 13 | 14 |
| 2017 January | 3 | 11 | 14 |
| 2016 December | 7 | 6 | 13 |
| 2016 November | 14 | 18 | 32 |
| 2016 October | 16 | 22 | 38 |
| 2016 September | 16 | 13 | 29 |
| 2016 August | 8 | 3 | 11 |
| 2016 July | 2 | 6 | 8 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 57 | 1 | 58 |
| 2015 September | 51 | 12 | 63 |
| 2015 August | 29 | 14 | 43 |
| 2015 July | 41 | 13 | 54 |
| 2015 June | 53 | 5 | 58 |
| 2015 May | 56 | 7 | 63 |
| 2015 April | 40 | 9 | 49 |
| 2015 March | 44 | 8 | 52 |
| 2015 February | 48 | 4 | 52 |
| 2015 January | 32 | 9 | 41 |
| 2014 December | 46 | 8 | 54 |
| 2014 November | 51 | 8 | 59 |
| 2014 October | 78 | 11 | 89 |
| 2014 September | 41 | 6 | 47 |
| 2014 August | 36 | 10 | 46 |
| 2014 July | 46 | 11 | 57 |
| 2014 June | 42 | 12 | 54 |
| 2014 May | 53 | 8 | 61 |
| 2014 April | 43 | 6 | 49 |
| 2014 March | 59 | 11 | 70 |
| 2014 February | 46 | 12 | 58 |
| 2014 January | 34 | 7 | 41 |
| 2013 December | 47 | 6 | 53 |
| 2013 November | 42 | 11 | 53 |
| 2013 October | 34 | 14 | 48 |
| 2013 September | 44 | 15 | 59 |
| 2013 August | 38 | 16 | 54 |
| 2013 July | 67 | 21 | 88 |
| 2013 June | 40 | 16 | 56 |
| 2013 May | 39 | 9 | 48 |
| 2013 April | 17 | 7 | 24 |
| 2013 March | 7 | 3 | 10 |
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