Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD
Abstract
:1. Introduction
2. Methods
2.1. Process
2.2. Measurement Tools
2.3. Ethical Factors
2.4. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
- Área de asma de SEPAR; Área de enfermería de SEPAR; Departamento de asma ALAT. SEPAR-ALAT consensus for inhaled therapies. Arch. Bronconeumol. 2013, 49, 2–14. [Google Scholar] [CrossRef]
- Duarte-de-Araújo, A.; Teixeira, P.; Hespanhol, V.; Correia-de-Sousa, J. COPD: Misuse of inhaler devices in clinical practice. Int. J. Chron. Obstruct. Pulmon. Dis. 2019, 14, 1209–1217. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ahn, J.H.; Chung, J.H.; Shin, K.-C.; Choi, E.Y.; Jin, H.J.; Lee, M.S.; Nam, M.J.; Lee, K.H. Critical inhaler handling error is an independent risk factor for frequent exacerbations of chronic obstructive pulmonary disease: Interim results of a single center prospective study. Int. J. Chronic Obstr. Pulm. Dis. 2019, 14, 2767–2775. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mahler, D.A. Peak inspiratory flow rate as a criterion for dry powder inhaler use in chronic obstructive pulmonary disease. Ann. Am. Thorac. Soc. 2017, 14, 1103–1107. [Google Scholar] [CrossRef]
- Loh, C.; Peters, S.P.; Lovings, T.M.; Ohar, J.A. Suboptimal inspiratory flow rates are associated with chronic obstructive pulmonary disease and all-cause readmissions. Ann. Am. Thorac. Soc. 2017, 14, 1305–1311. [Google Scholar] [CrossRef]
- Mahler, D.A. The role of inspiratory flow in selection and use of inhaled therapy for patients with chronic obstructive pulmonary disease. Respir. Med. 2020, 161, 105857. [Google Scholar] [CrossRef]
- Branco Ferreira, M.; Santos, A.; Clode, M.H.; Palma Carlos, A.G. Turbutest in the training of asthmatic Turbuhaler users. Allergy 1999, 54, 375–379. [Google Scholar] [CrossRef]
- Broeders, M.E.A.C.; Molema, J.; Vermue, N.A.; Folgering, H.T.M. In check dial: Accuracy for Diskus and Turbuhaler. Int. J. Pharm. 2003, 252, 275–280. [Google Scholar] [CrossRef]
- Sanders, M.J. Guiding inspiratory flow: Development of the in-check DIAL G16, a tool for improving inhaler technique. Pulm. Med. 2017, 2017, 1495867. [Google Scholar] [CrossRef] [Green Version]
- Miravitlles, M.; Soler-Cataluña, J.J.; Calle, M.; Molina, J.; Almagro, P.; Quintano, J.A.; Trigueros, J.A.; Cosio, B.G.; Casanova, C. Spanish guidelines for management of chronic obstructive pulmonary disease (GesEPOC) 2017. Pharmacological treatment of stable phase. Arch. Bronconeumol. 2017, 53, 324–335. [Google Scholar] [CrossRef]
- Singh, D.; Agusti, A.; Anzueto, A.; Barnes, P.J.; Bourbeau, J.; Celli, B.R.; Criner, G.J.; Frith, P.; Halpin, D.M.G.; Han, M.; et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: The GOLD science committee report 2019. Eur. Respir. J. 2019, 53, 1900164. [Google Scholar] [CrossRef] [PubMed]
- Agusti, A.; Fernández-Villar, A.; Capelastegui, A.; García-Losa, M.; Velasco, B.; Sánchez, G. Validity study of Catalan, Galician and Basque language versions of the COPD assessment test and equivalence with the Spanish version. Arch. Bronconeumol. 2017, 53, 311–317. [Google Scholar] [CrossRef] [PubMed]
- Plaza, V.; Fernández-Rodríguez, C.; Melero, C.; Cosío, B.G.; Entrenas, L.M.; De Llano, L.P.; Gutiérrez-Pereyra, F.; Tarragona, E.; Palomino, R.; López-Viña, A.; et al. Validation of the test of the adherence to inhalers; (TAI) for Asthma and COPD patients. J. Aerosol Med. Pulm. Drug Deliv. 2016, 29, 142–152. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tordera, M.P.; Viejo, J.L.; Sanchis, J.; Badia, X.; Cobos, N.; Picado, C.; Sobradillo, V.; Del Río, J.M.G.; Duce, F.; Cabrera, L.M. Assessment of patient satisfaction and preferences with inhalers in asthma with the FSI-10 Questionnaire. Arch. Bronconeumol. 2008, 44, 346–352. [Google Scholar] [CrossRef]
- García-Río, F.; Calle, M.; Burgos, F.; Casan, P.; del Campo, F.; Galdiz, J.B.; Giner, J.; Gonzalez-Mangado, N.; Ortega, F.; Puente Maestu, L. Espirometría. Arch. Bronconeumol. 2013, 49, 388–401. [Google Scholar] [CrossRef]
- Modin, H.E.; Fathi, J.T.; Gilbert, C.R.; Wilshire, C.L.; Wilson, A.K.; Aye, R.W.; Farivar, A.S.; Louie, B.E.; Vallieres, E.; Gorden, J.A. Pack-year cigarette smoking history for determination of lung cancer screening eligibility. Comparison of the electronic medical record versus a shared decision-making conversation. Ann. Am. Thorac. Soc. 2017, 14, 1320–1325. [Google Scholar] [CrossRef]
- Chouaid, C.; Germain, N.; De Pouvourville, G.; Aballéa, S.; Korchagina, D.; Baldwin, M.; Le Lay, K.; Luciani, L.; Toumi, M.; DeVillier, P. Patient preference for chronic obstructive pulmonary disease (COPD) treatment inhalers: A discrete choice experiment in France. Curr. Med. Res. Opin. 2019, 35, 785–792. [Google Scholar] [CrossRef] [Green Version]
- Hira, D.; Koide, H.; Nakamura, S.; Okada, T.; Ishizeki, K.; Yamaguchi, M.; Koshiyama, S.; Oguma, T.; Ito, K.; Funayama, S.; et al. Assessment of inhalation flow patterns of soft mist inhaler co-prescribed with dry powder inhaler using inspiratory flow meter for multi inhalation devices. PLoS ONE 2018, 13, e0193082. [Google Scholar] [CrossRef] [Green Version]
- Ghosh, S.; Pleasants, R.A.; Ohar, J.A.; Donohue, J.F.; Drummond, M.B. Prevalence and factors associated with suboptimal peak inspiratory flow rates in COPD. Int. J. Chronic Obstr. Pulm. Dis. 2019, 14, 585–595. [Google Scholar] [CrossRef] [Green Version]
- Soriano, J.B.; Alfageme, I.; Miravitlles, M.; De Lucas, P.; Soler-Cataluña, J.J.; García-Río, F.; Casanova, C.; González-Moro, J.M.R.; Cosío, B.G.; Sánchez, G.; et al. Prevalence and determinants of COPD in Spain: EPISCAN II. Arch. Bronconeumol. 2020. [Google Scholar] [CrossRef]
- Delgado, A.; Saletti-Cuesta, L.; López-Fernández, L.A.; Gil-Garrido, N.; Castillo, J.D.D.L.D. Gender inequalities in COPD decision-making in primary care. Respir. Med. 2016, 114, 91–96. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pérez, T.A.; Castillo, E.G.; Ancochea, J.; Sanz, M.T.P.; Almagro, P.; Martínez-Camblor, P.; Miravitlles, M.; Carballeira, M.R.-; Navarro, A.; Lamprecht, B.; et al. Sex differences between women and men with COPD: A new analysis of the 3CIA study. Respir. Med. 2020, 171. [Google Scholar] [CrossRef] [PubMed]
- Han, M.K. Chronic obstructive pulmonary disease in women: A biologically focused review with a systematic search strategy. Int. J. Chronic Obstr. Pulm. Dis. 2020, 15, 711–721. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Malmberg, L.P. Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: Age and gender rather than severity matters. Int. J. Chronic Obstr. Pulm. Dis. 2010, 5, 257–262. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sharma, G.; Mahler, D.A.; Mayorga, V.M.; Deering, K.L.; Harshaw, Q.; Ganapathy, V. Prevalence of low peak inspiratory flow rate at discharge in patients hospitalized for COPD exacerbation. Chronic Obstr. Pulm. Dis. J. COPD Found. 2017, 4, 217–224. [Google Scholar] [CrossRef]
- Harb, H.S.; Laz, N.I.; Rabea, H.; Abdelrahim, M.E.A. Prevalence and predictors of suboptimal peak inspiratory flow rate in COPD patients. Eur. J. Pharm. Sci. 2020, 147, 105298. [Google Scholar] [CrossRef]
- Ghosh, S.; Ohar, J.A.; Drummond, M.B. Peak Inspiratory flow rate in chronic obstructive pulmonary disease: Implications for dry powder inhalers. J. Aerosol Med. Pulm. Drug Deliv. 2017, 30, 381–387. [Google Scholar] [CrossRef]
- Mahler, D.A.; Waterman, L.A.; Gifford, A.H. Prevalence and COPD phenotype for a suboptimal peak inspiratory flow rate against the simulated resistance of the Diskus© dry powder inhaler. J. Aerosol Med. Pulm. Drug Deliv. 2013, 26, 174–179. [Google Scholar] [CrossRef]
- Janssens, W.; Vandenbrande, P.; Hardeman, E.; De Langhe, E.; Philps, T.; Troosters, T.; Decramer, M. Inspiratory flow rates at different levels of resistance in elderly COPD patients. Eur. Respir. J. 2008, 31, 78–83. [Google Scholar] [CrossRef]
- Kawamatawong, T.; Khiawwan, S.; Pornsuriyasak, P. Peak inspiratory flow rate measurement by using in-check DIAL for the different inhaler devices in elderly with obstructive airway diseases. J. Asthma Allergy 2017, 10, 17–21. [Google Scholar] [CrossRef] [Green Version]
- Duarte, A.G.; Tung, L.; Zhang, W.; Hsu, E.S.; Kuo, Y.-F.; Sharma, G. Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD. Chronic Obstr. Pulm. Dis. J. COPD Found. 2019, 6, 246–255. [Google Scholar] [CrossRef] [PubMed]
- Bernabeu-Mora, R.; Oliveira-Sousa, S.L.; Sánchez-Martínez, M.P.; García-Vidal, J.A.; Gacto-Sánchez, M.; Medina-Mirapeix, F. Frailty transitions and associated clinical outcomes in patients with stable COPD: A longitudinal study. PLoS ONE 2020, 15, e0230116. [Google Scholar] [CrossRef] [PubMed]
- Chen, S.Y.; Huang, C.K.; Peng, H.C.; Yu, C.J.; Chien, J.Y. Inappropriate peak inspiratory flow rate with dry powder inhaler in chronic obstructive pulmonary disease. Sci. Rep. 2020, 10, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Prime, D.; De Backer, W.; Hamilton, M.; Cahn, A.; Preece, A.; Kelleher, D.; Baines, A.; Moore, A.; Brealey, N.; Moynihan, J. Effect of disease severity in asthma and chronic obstructive pulmonary disease on inhaler-specific inhalation profiles through the ELLIPTA© dry powder inhaler. J. Aerosol Med. Pulm. Drug Deliv. 2015, 28, 486–497. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sepúlveda-Loyola, W.; Osadnik, C.; Phu, S.; Morita, A.A.; Duque, G.; Probst, V.S. Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: A systematic review and meta-analysis. J. Cachex Sarcopenia Muscle 2020, 11, 1164–1176. [Google Scholar] [CrossRef] [PubMed]
- Scullion, J. The nurse practitioners perspective on inhaler education in asthma and chronic obstructive pulmonary disease. Can. Respir. J. 2018, 2018, 1–9. [Google Scholar] [CrossRef] [Green Version]
- Loh, C.H.; Ohar, J.A. Personalization of device therapy—Prime time for peak inspiratory flow rate. Chronic Obstr. Pulm. Dis. J. COPD Found. 2017, 4, 172–176. [Google Scholar] [CrossRef] [Green Version]
Total (n = 122) | Adequate PIF (n = 88) | Sub-Optimal PIF (n = 34) | p Value * | |
---|---|---|---|---|
Males | 106 (87%) | 76 (86%) | 30 (88%) | 0.99 |
Age (years) | 68 ± 10 | 67 ± 10 | 72 ± 10 | 0.09 |
Primary education | 78 (64%) | 53 (60%) | 25 (74%) | 0.17 |
Active smoking | 49 (40%) | 34 (39%) | 15 (44%) | 0.58 |
BMI (Kg/m2) | 28.4 ± 5.6 | 28.4 ± 5.4 | 28.5 ± 6.1 | 0.9 |
Forced expiratory volume in 1 s (FEV1) (mL) | 1350 ± 528 | 1387 ± 562 | 1129 ± 371 | 0.04 |
FEV1 (%) | 47 ± 16 | 49 ± 17 | 43 ± 14 | 0.08 |
Forced vital capacity (FVC) (mL) | 2852 ± 908 | 3005 ± 982 | 2456 ± 500 | <0.01 |
FVC (%) | 77 ± 18 | 80 ± 19 | 70 ± 12 | <0.01 |
Resistance * | Number of Patients | PIF (L/min) | Sub-Optimal PIF |
---|---|---|---|
R1 | 49 | 95 (21) | 5 (10.2%) |
R2 | 33 | 74 (18) | 6 (18.1%) |
R3 | 17 | 74 (19) | 2 (11.7%) |
R4 | 65 | 62 (14) | 26 (40%) |
R5 | 22 | 40 (12) | 3 (13.6%) |
Total (n = 122) | Adequate PIF (n = 88) | Sub-Optimal PIF (n = 34) | p Value * | |
---|---|---|---|---|
Some critical error in inhalation technique | 73 (60%) | 47 (53%) | 26 (77%) | 0.02 |
Intermediate or bad adherence (TAI) | 32 (26%) | 27 (31%) | 5 (15%) | 0.07 |
Erratic non-compliance | 21 (17%) | 19 (22%) | 2 (6%) | 0.04 |
Deliberate non-compliance | 11 (9%) | 11 (13%) | 0 (0%) | 0.03 |
Unconscious non-compliance | 74 (61%) | 47 (53%) | 27 (79%) | <0.01 |
FSI-10 (score) | 44.7 ± 5.8 | 45.3 ± 5.6 | 43.5 ± 6.1 | 0.13 |
Medium/low satisfaction (FSI-10) | 25 (21%) | 17 (19%) | 9 (27%) | 0.39 |
Number of exacerbations in last year | 1.2 ± 1.4 | 1.06 ± 1.3 | 1.56 ± 1.3 | 0.06 |
≥2 exacerbations in last year | 38 (31%) | 22 (25%) | 16 (47%) | 0.02 |
No exacerbations in last year | 46 (38%) | 37 (42%) | 9 (27%) | 0.11 |
Dyspnea score (mMRC) | 1.6 ± 1 | 1.63 ± 1 | 1.73 ± 1.1 | 0.63 |
3–4 mMRC dyspnea score | 20 (16%) | 14 (16%) | 6 (18%) | 0.81 |
CAT score | 15 ± 7 | 15 ± 8 | 15 ± 6 | 0.99 |
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Represas-Represas, C.; Aballe-Santos, L.; Fernández-García, A.; Priegue-Carrera, A.; López-Campos, J.-L.; González-Montaos, A.; Botana-Rial, M.; Fernández-Villar, A. Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD. J. Clin. Med. 2020, 9, 3949. https://doi.org/10.3390/jcm9123949
Represas-Represas C, Aballe-Santos L, Fernández-García A, Priegue-Carrera A, López-Campos J-L, González-Montaos A, Botana-Rial M, Fernández-Villar A. Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD. Journal of Clinical Medicine. 2020; 9(12):3949. https://doi.org/10.3390/jcm9123949
Chicago/Turabian StyleRepresas-Represas, Cristina, Luz Aballe-Santos, Alberto Fernández-García, Ana Priegue-Carrera, José-Luis López-Campos, Almudena González-Montaos, Maribel Botana-Rial, and Alberto Fernández-Villar. 2020. "Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD" Journal of Clinical Medicine 9, no. 12: 3949. https://doi.org/10.3390/jcm9123949