Abstract:
BACKGROUND:Researchers, using checklists, have identified that 30%-90% of patients make errors in inhaler use. It is not certain whether these errors affect the delivery of medication. We have developed an electronic monitor (INCA™) that records audio each time an inhaler is used, providing objective information on inhaler technique. The aim of this study was to assess the effect that correctly identified inhaler errors, with the INCA device, have on drug delivery. METHODS:This was a prospective study of healthy volunteers using a salbutamol Diskus™. The inclusion criteria allowed for the recruitment of healthy participants who were nonfrequent users of Salbutamol. Each participant was assigned to one control "phase" first and two/three subsequent error "phases." Each phase consisted of six doses of the drug taken 6 hours apart, and the participants' blood was drawn before and 25 minutes after doses one and six. This allowed us to sample their trough and peak serum salbutamol levels. RESULTS:Fourteen healthy volunteers were studied. The inhaler technique errors simulated in this study included exhaling into the device after drug priming but before inhalation, low inspiratory flow, multiple inhalations, low breath hold, missed doses, and wrong inhaler position. Only the exhalation error, low inspiratory flow, and missed doses led to a significant reduction in serum salbutamol levels. After six doses of the exhalation error, there was a 62% reduction in peak salbutamol levels. Low inspiratory flow led to a 52% reduction in peak salbutamol levels and a 78% reduction in trough levels. Missed doses led to a 37% reduction in trough salbutamol levels. CONCLUSIONS:These findings confirm that technique errors affect drug delivery. Furthermore, we were able to identify that the most critical technique errors with the Diskus inhaler are exhalation into the device before inhalation, poor inspiratory flow, and missing doses.
journal_name
J Aerosol Med Pulm Drug Delivjournal_title
Journal of aerosol medicine and pulmonary drug deliveryauthors
Sulaiman I,Seheult J,Sadasivuni N,MacHale E,Killane I,Giannoutsos S,Cushen B,Mokoka MC,Bhreathnach AS,Boland F,Reilly RB,Costello RWdoi
10.1089/jamp.2016.1334subject
Has Abstractpub_date
2017-08-01 00:00:00pages
247-255issue
4eissn
1941-2711issn
1941-2703journal_volume
30pub_type
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pub_type: 杂志文章
doi:10.1089/jamp.2017.1438
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doi:10.1089/jamp.2017.1376
更新日期:2018-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2011.0925
更新日期:2012-08-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2009.0793
更新日期:2010-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:10.1089/jamp.2017.1412
更新日期:2018-08-01 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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更新日期:2017-08-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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更新日期:2011-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-02-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章,随机对照试验
doi:10.1089/jamp.2008.0690
更新日期:2008-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/jamp.2020.1635
更新日期:2020-09-23 00:00:00