Abstract:
Introduction:Training in correct inhaler use, ideally in person or by video demonstration, can minimize errors but is rarely provided in clinics. This open-label, low-intervention study evaluated critical error rates with dry-powder inhalers (DPIs), before and after training, in patients with chronic obstructive pulmonary disease. Methods:Patients prescribed an inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) (ELLIPTA, Turbuhaler, or DISKUS), long-acting muscarinic antagonist (LAMA)/LABA (ELLIPTA or Breezhaler), or LAMA-only DPI (ELLIPTA, HandiHaler, or Breezhaler) were enrolled. Critical errors were assessed before training (Visit 1 [V1]; primary endpoint) and 6 weeks thereafter (Visit 2 [V2]; secondary endpoint). Logistic regression models were used to calculate odds ratios (ORs) for between-group comparisons. Results:The intent-to-treat population comprised 450 patients. At V1, fewer patients made ≥1 critical error with ELLIPTA (10%) versus other ICS/LABA DPIs (Turbuhaler: 40%, OR 4.66, P=0.005; DISKUS: 26%, OR 2.48, P=0.114) and other LAMA or LAMA/LABA DPIs (HandiHaler: 34%, OR 3.50, P=0.026; Breezhaler: 33%, OR 3.94, P=0.012). Critical error rates with the primary ICS/LABA DPI were not significantly different between ELLIPTA ICS/LABA (10%) and ICS/LABA plus LAMA groups (12-25%). Critical errors with the primary ICS/LABA DPI occurred less frequently with ELLIPTA ICS/LABA with or without LAMA (11%) versus Turbuhaler ICS/LABA with or without LAMA (39%, OR 3.99, P<0.001) and DISKUS ICS/LABA with or without LAMA (26%, OR 2.18, P=0.069). Simulating single-inhaler versus multiple-inhaler triple therapy, critical error rates were lower with ELLIPTA fluticasone furoate/vilanterol (FF/VI; 10%) versus ELLIPTA FF/VI plus LAMA (22%), considering errors with either DPI (OR 2.50, P=0.108). At V2, critical error rates decreased for all DPIs/groups, reaching zero only for ELLIPTA. Between-group comparisons were similar to V1. Conclusion:Fewer patients made critical errors with ELLIPTA versus other ICS/LABA, and LAMA or LAMA/LABA DPIs. The effect of "verbal" training highlights its importance for reducing critical errors with common DPIs.
journal_name
Int J Chron Obstruct Pulmon Disauthors
Collier DJ,Wielders P,van der Palen J,Heyes L,Midwinter D,Collison K,Preece A,Barnes N,Sharma Rdoi
10.2147/COPD.S224209subject
Has Abstractpub_date
2020-06-09 00:00:00pages
1301-1313eissn
1176-9106issn
1178-2005pii
224209journal_volume
15pub_type
杂志文章abstract:STUDY OBJECTIVES:Patients with chronic obstructive pulmonary disease (COPD) have low exercise capacity and low content of high energetic phosphates in their skeletal muscles. The aim of the present study was to investigate whether creatine supplementation together with exercise training may increase physical performanc...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,随机对照试验
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更新日期:2006-01-01 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2017-12-12 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,随机对照试验
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更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
doi:10.2147/COPD.S147796
更新日期:2017-12-27 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-19 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S245819
更新日期:2020-06-04 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/copd.s5102
更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2020-01-13 00:00:00
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pub_type: 杂志文章
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更新日期:2010-08-09 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-12-08 00:00:00
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pub_type: 杂志文章
doi:10.2147/COPD.S121294
更新日期:2017-01-17 00:00:00
abstract:Introduction:Long-term use of nebulized or oral antibiotics is common in the treatment of cystic fibrosis and non-cystic fibrosis bronchiectasis. To date, however, few studies have focused on the use of nebulized antibiotics in COPD patients. The aims of this study are: to establish whether a combination of nebulized c...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S209513
更新日期:2019-10-17 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-05-20 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
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更新日期:2015-08-31 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S162484
更新日期:2018-06-06 00:00:00