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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To investigate a group of patients&#39; preferences among 3 dry powder inhalers&#8212;Accuhaler&#174;&#44; Easyhaler&#174;&#44; and Turbuhaler&#174;&#8212;and to analyze the features that were most important for motivating choices&#46;</p> <span class="elsevierStyleSectionTitle">Material and method</span><p class="elsevierStyleSimplePara elsevierViewall">The study enrolled 30 patients with stable asthma with a mean &#40;SD&#41; age of 40 &#40;13&#41; and who habitually used inhaled corticosteroids&#46; The patients were shown in detail how to use each of the devices and were randomized to begin using them in different orders&#46; After using each inhaler for a week&#44; the patients assessed 9 different features on a scale of 0 to 10 with an independent observer&#46; The patients were asked to put the inhalers in order of preference&#44; and finally to demonstrate they could use them correctly&#46;</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&#46; The mean final scores out of 90 of the 9 features evaluated were 75 &#40;13&#41; for the Easyhaler&#44; 67 &#40;12&#41; for the Accuhaler&#44; and 65 &#40;14&#41; for the Turbuhaler&#46; Differences were statistically significant between the first and the second device &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;02&#41; and the first and the third &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41; but not between the Accuhaler and the Turbuhaler &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;376&#41;&#46; Mean rating scores were 8&#46;6 &#40;1&#46;4&#41; for the Easyhaler&#44; 7&#46;3 &#40;1&#46;9&#41; for the Turbuhaler&#44; and 7&#46;1 &#40;1&#46;6&#41; for the Accuhaler&#46; The Easyhaler was the first choice for 53&#37; of patients&#44; the Turbuhaler for 27&#37;&#44; and the Accuhaler for 20&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The Easyhaler was rated the highest by the patients in the study&#46; The scores were a long way from the maximum score&#44; so research into developing an ideal inhaler must continue&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer las preferencias de un grupo de pacientes acerca de 3 dispositivos de inhalaci&#243;n en polvo &#8211;Accuhaler&#174;&#44; Easyhaler&#174; y Turbuhaler&#174; &#8211; y analizar los aspectos m&#225;s importantes que motivan su elecci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; a 30 pacientes de 40 &#177; 13 a&#241;os&#44; asm&#225;ticos y estables&#44; que se administraban habitualmente corticoides inhalados&#46; Se les explic&#243; detalladamente la t&#233;cnica de utilizaci&#243;n de cada uno de los dispositivos y&#44; de forma aleatoria&#44; se asign&#243; el orden en que deb&#237;an utilizarlos&#46; Tras una semana de usar cada uno de los dispositivos&#44; un observador independiente evalu&#243; 9 aspectos distintos de los dispositivos&#44; valorados de 0 a 10 puntos&#46; Se pidi&#243; a los pacientes que determinaran el orden de preferencia y finalmente se evalu&#243; la t&#233;cnica de utilizaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes realizaron correctamente la t&#233;cnica de inhalaci&#243;n&#44; al principio y al final del estudio&#46; Las puntuaciones totales de los 9 aspectos evaluados&#44; sobre 90 puntos&#44; fueron de 75 &#177; 13 puntos para Easyhaler&#44; de 67 &#177; 12 para Accuhaler y de 65 &#177; 14 para Turbuhaler&#46; Las diferencias fueron estad&#237;sticamente significativas entre el primero y el segundo &#40;p &#61; 0&#44;02&#41; y entre el primero y el tercero &#40;p &#61; 0&#44;001&#41;&#44; pero no para Accuhaler y Turbuhaler &#40;p &#61; 0&#44;376&#41;&#46; Las medias de los valores fueron de 8&#44;6 &#177; 1&#44;4 para Easyhaler&#44; de 7&#44;3 &#177; 1&#44;9 para Turbuhaler y de 7&#44;1 &#177; 1&#44;6 para Accuhaler&#46; El 53&#37; de los pacientes escogi&#243; el dispositivo Easyhaler&#44; el 27&#37; el Turbuhaler y el 20&#37; el Accuhaler&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">El dispositivo Easyhaler fue el mejor valorado por los pacientes evaluados&#46; Las puntuaciones obtenidas para cada dispositivo distan de la puntuaci&#243;n m&#225;xima&#44; por lo que deber&#225; continuar investig&#225;ndose para obtener el inhalador ideal&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Adherence with twice-daily dosing of inhaled steroids&#46; Socioeconomic and health-belief differences"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "AJ Apter"
                            1 => "ST Reisine"
                            2 => "G Affleck"
                            3 => "E Barrows"
                            4 => "RL ZuWallack"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "1810"
                        "paginaFinal" => "1817"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9620910"
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                      "titulo" => "International variations in asthma treatment compliance&#58; the results of the European Community Respiratory Health Survey &#40;ECRHS&#41;"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I Cerveri"
                            1 => "F Locatelli"
                            2 => "MC Zoia"
                            3 => "A Corsico"
                            4 => "S Accordini"
                            5 => "R de Marco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
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                        "paginaInicial" => "288"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
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                        "paginaFinal" => "559"
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                      ]
                    ]
                  ]
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                    0 => array:1 [
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                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
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                          "autores" => array:5 [
                            0 => "C Put"
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                            2 => "V Lemaigre"
                            3 => "M Demedts"
                            4 => "G Verleden"
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                          "autores" => array:6 [
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                            5 => "I Mart&#237;nez"
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                        "paginaFinal" => "43"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10726183"
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                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2002"
                        "volumen" => "38"
                        "paginaInicial" => "300"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12199928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breath-actuated inhalers in chronic asthma&#58; comparison of Diskhaler and Turbohaler for delivery of beta-agonists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "PH Brown"
                            1 => "J Lenney"
                            2 => "S Armstrong"
                            3 => "AC Ning"
                            4 => "GK Crompton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1992"
                        "volumen" => "5"
                        "paginaInicial" => "1143"
                        "paginaFinal" => "1145"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1358674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of the acceptability to the Ventolin metered-dose inhaler and Bricanyl Turbuhaler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "JS Vilsvik"
                            1 => "N Ringdal"
                            2 => "T Albrektsen"
                            3 => "S Holthe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Allergy"
                        "fecha" => "1993"
                        "volumen" => "70"
                        "paginaInicial" => "300"
                        "paginaFinal" => "304"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of the clinical efficacy and patient acceptability of terbutaline Turbuhaler and salbutamol Rotahaler&#44; in adult patients with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D Gioulekas"
                            1 => "D Papakosta"
                            2 => "P Vordoyianni"
                            3 => "H Baloti"
                            4 => "C Vamvalis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "1996"
                        "volumen" => "90"
                        "paginaInicial" => "205"
                        "paginaFinal" => "209"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8736653"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapeutic equivalence and acceptability of two multidose powder inhalers in the treatment of asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R Wettengel"
                            1 => "K Laurikainen"
                            2 => "M Silvasti"
                            3 => "P Toivanen"
                            4 => "K Sauter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "29467"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2000"
                        "volumen" => "67"
                        "paginaInicial" => "77"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10705267"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beclomethasone dipropionate Easyhaler is as effective as budesonide Turbohaler in the control of asthma and is preferred by patients&#46; German Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L Jager"
                            1 => "K Laurikainen"
                            2 => "M Leinonen"
                            3 => "M Silvasti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Clin Pract"
                        "fecha" => "2000"
                        "volumen" => "54"
                        "paginaInicial" => "368"
                        "paginaFinal" => "372"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11092110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Salbutamol via Easyhaler is at least as effective as salbutamol via Turbuhaler in the treatment of histamine-induced bronchoconstriction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O Zetterstrom"
                            1 => "S Lahelma"
                            2 => "J Keski-Karhu"
                            3 => "M Silvasti"
                            4 => "E Ostling-Kulling"
                            5 => "A Ahonen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2000"
                        "volumen" => "94"
                        "paginaInicial" => "1097"
                        "paginaFinal" => "1102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11127498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Finnish Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H Tukianen"
                            1 => "P Rytila"
                            2 => "KM Hamalainen"
                            3 => "MS Silvasti"
                            4 => "J Keski-Karhu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2002"
                        "volumen" => "96"
                        "paginaInicial" => "221"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12000000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhalation Devices Study Group&#46; Patient perception and acceptability of multidose dry powder inhalers&#58; a randomized crossover comparison of Diskus&#47;Accuhaler with Turbuhaler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J Serra-Batlles"
                            1 => "V Plaza"
                            2 => "C Badiola"
                            3 => "E Morej&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Aerolsol Med"
                        "fecha" => "2002"
                        "volumen" => "15"
                        "paginaInicial" => "59"
                        "paginaFinal" => "64"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of two budesonide powder inhalers&#44; Easyhaler and Turbuhaler&#44; in steroid-na&#239;ve asthmatic patients"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "German Study Group"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H Schweisfurth"
                            1 => "A Malinen"
                            2 => "T Koskela"
                            3 => "P Toivanen"
                            4 => "M Ranki-Pesonen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2002"
                        "volumen" => "96"
                        "paginaInicial" => "599"
                        "paginaFinal" => "606"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12195841"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Vol. 40. Issue 3.
Pages 106-109 (March 2004)
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Vol. 40. Issue 3.
Pages 106-109 (March 2004)
Original Articles
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Patient Preference in the Choice of Dry Powder Inhalers
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J. Giner
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
, M. Torrejón, A. Ramos, P. Casan, C. Granel, V. Plaza, J. Belda, J. Sanchis
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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Article information
Objective

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.

Material and method

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.

Results

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 (P=0.02) and the first and the third (P=.001) but not between the Accuhaler and the Turbuhaler (P=.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%.

Conclusions

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.

Key words:
Asthma
Dry powder inhalers
Preferences
Objetivo

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.

Material y método

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.

Resultados

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.

Conclusions

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.

Palabras clave:
Asma
Inhaladores en polvo
Preferencias
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REFERENCES
[1]
AJ Apter, ST Reisine, G Affleck, E Barrows, RL ZuWallack.
Adherence with twice-daily dosing of inhaled steroids. Socioeconomic and health-belief differences.
Am J Respir Crit Care Med, 157 (1998), pp. 1810-1817
[2]
I Cerveri, F Locatelli, MC Zoia, A Corsico, S Accordini, R de Marco.
International variations in asthma treatment compliance: the results of the European Community Respiratory Health Survey (ECRHS).
Eur Respir J, 14 (1999), pp. 288-294
[3]
BG Bender.
Overcoming barriers to non adherence in asthma treatment.
J Allergy Clin Immunol, 109 (2002), pp. 554-559
[4]
CV Chambers, L Markson, JJ Diamond, L Lasch, M Berger.
Health beliefs and compliance with inhaled corticosteroids by asthmatic patients in primary care practices.
Respir Med, 93 (1999), pp. 88-94
[5]
C Put, O van den Bergh, V Lemaigre, M Demedts, G Verleden.
Evaluation of an individualised asthma programme directed at behavioural change.
Eur Respir J, 21 (2003), pp. 109-115
[6]
Global Initiative for Asthma, GINA.
National Institutes of Health. National Health Lung and Blood Institute.
[7]
J Giner, LV Basualdo, P Casan, C Hernández, V Macián, I Martínez, et al.
Normativa sobre la utilización de fármacos inhalados.
Arch Bronconeumol, 36 (2000), pp. 34-43
[8]
J Giner, V Macián, C Hernandez, EDEN Group.
Multicenter prospective study of respiratory patient education and instruction in the use of inhalers (EDEN study).
Arch Bronconeumol, 38 (2002), pp. 300-305
[9]
PH Brown, J Lenney, S Armstrong, AC Ning, GK Crompton.
Breath-actuated inhalers in chronic asthma: comparison of Diskhaler and Turbohaler for delivery of beta-agonists.
Eur Respir J, 5 (1992), pp. 1143-1145
[10]
JS Vilsvik, N Ringdal, T Albrektsen, S Holthe.
Comparison of the acceptability to the Ventolin metered-dose inhaler and Bricanyl Turbuhaler.
Ann Allergy, 70 (1993), pp. 300-304
[11]
D Gioulekas, D Papakosta, P Vordoyianni, H Baloti, C Vamvalis.
A comparison of the clinical efficacy and patient acceptability of terbutaline Turbuhaler and salbutamol Rotahaler, in adult patients with asthma.
Respir Med, 90 (1996), pp. 205-209
[12]
R Wettengel, K Laurikainen, M Silvasti, P Toivanen, K Sauter.
Therapeutic equivalence and acceptability of two multidose powder inhalers in the treatment of asthma.
Respiration, 67 (2000), pp. 77-82
[13]
L Jager, K Laurikainen, M Leinonen, M Silvasti.
Beclomethasone dipropionate Easyhaler is as effective as budesonide Turbohaler in the control of asthma and is preferred by patients. German Study Group.
Int J Clin Pract, 54 (2000), pp. 368-372
[14]
O Zetterstrom, S Lahelma, J Keski-Karhu, M Silvasti, E Ostling-Kulling, A Ahonen.
Salbutamol via Easyhaler is at least as effective as salbutamol via Turbuhaler in the treatment of histamine-induced bronchoconstriction.
Respir Med, 94 (2000), pp. 1097-1102
[15]
H Tukianen, P Rytila, KM Hamalainen, MS Silvasti, J Keski-Karhu.
The Finnish Study Group.
Respir Med, 96 (2002), pp. 221-229
[16]
J Serra-Batlles, V Plaza, C Badiola, E Morejón.
Inhalation Devices Study Group. Patient perception and acceptability of multidose dry powder inhalers: a randomized crossover comparison of Diskus/Accuhaler with Turbuhaler.
J Aerolsol Med, 15 (2002), pp. 59-64
[17]
H Schweisfurth, A Malinen, T Koskela, P Toivanen, M Ranki-Pesonen, German Study Group.
Comparison of two budesonide powder inhalers, Easyhaler and Turbuhaler, in steroid-naïve asthmatic patients.
Respir Med, 96 (2002), pp. 599-606
Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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