Aerosol delivery devices.
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Administration, Inhalation↗
Biomedical subjects
Graham K Crompton
Publications and source records attributed to Graham K Crompton.
How to achieve good compliance with inhaled asthma therapy.
Inability to use inhaler devices correctly is a major source of non-compliance in patients with asthma. The problem of coordinating dose release with inspiration seen with pressurised metered dose inhalers (pMDIs) is overcome by dry powder inhalers (DPIs), since they use inspiratory flow energy to carry the drug dose to the respiratory tract. The first DPIs were not popular because they were single dose devices and inconvenient to use. The introduction of multiple dose DPIs improved the image of the dry powder systems in the eyes of both the clinician and the patient. The continued development of DPIs has led to inhaler devices which include dose counters, are easy to use, are refillable and provide feedback to the patient on a correct inhalation. Criteria that may improve patient compliance with an inhaler include: correct use of the device by most patients; ease and convenience of device use; dose release even at low inspiratory flow rates; feedback of drug release which could instill confidence that the dose has been inhaled; cartridge refills and overall confidence in the device. The Novolizer has all the desirable features listed above and is expected to improve compliance if prescribed for the large number of patients who cannot use the conventional pMDI or less efficient DPSs.
Administration, Inhalation↗
Moving from CFC aerosol to HFA aerosol or dry powder inhalers: what do patients think?
BACKGROUND/OBJECTIVES: Environmentally friendly hydrofluoroalkane (HFA) pressurised metered-dose inhalers are currently being marketed to replace chlorofluorocarbon (CFC)-driven devices. It is uncertain whether these new formulations with different properties are acceptable to patients. Similarly, switching a patient to a dry powder inhaler (DPI) carries the risk of non-acceptance. METHODS: One hundred patients with obstructive airway disease on regular CFC aerosol inhaler medication underwent a standardised, structured interview. During the interview patients were asked to use a new HFA aerosol inhaler and three DPIs in random order. Patients' notions were recorded. RESULTS: Most patients (96) agreed to change from their CFC to the HFA inhaler, of those, only 12 did so with some reservation. Properties (taste, user-friendliness, design) of the HFA inhaler were rated favourably. DPIs represented an acceptable alternative to aerosol inhalers. In fact, 57 patients preferred a DPI over the HFA inhaler. Not all powder devices were equally acceptable. Replacing the CFC inhaler with patients' preferred alternative devices resulted in a more than 3-fold increase in costs. CONCLUSION: Concerns about the acceptability of reformulated CFC-free aerosol inhalers are ill founded. However, if given the choice, many patients prefer a DPI over the HFA inhaler. The transition offers an opportunity to review patients' current treatment and the proficiency of their inhaling technique. Moving to CFC-free inhalers will have revenue implications.
Adolescent↗