Abstract
Introduction
In addition to offering favorable pharmaceutical performance, an ideal inhaler should be well accepted by patients, as this may facilitate compliance. We report a study that specifically assessed inhaler preference in patients with obstructive lung disease after treatment with ipratropium bromide/fenoterol hydrobromide (Berodual®) delivered via either Respimat® Soft Mist™ Inhaler (SMI) or hydrofluoroalkane metered dose inhaler (HFA-MDI).
Methods
Patients with COPD, asthma or mixed disease were randomized to receive ipratropium bromide/fenoterol hydrobromide 20/50µg via Respimat® SMI or 40/100µg via HFA-MDI for 7 weeks each, in a crossover design. Patients were trained in inhaler use and given ≤5 attempts to demonstrate satisfactory technique. At the end of each treatment period, patients completed a 15-item satisfaction questionnaire, and inhaler technique was re-tested. On study completion, patients were asked which inhaler they preferred and they rated their willingness to continue using each inhaler. Clinical efficacy outcomes were measured by diary card to check whether switching inhaler affected efficacy.
Results
In total, 245 patients were randomized and 224 used both inhalers within their respective treatment periods. Of 201 patients expressing a preference, 162 (81%) preferred Respimat® SMI and 39 (19%) preferred HFA-MDI (p < 0.001). Patients would rather continue using Respimat® SMI than HFA-MDI (p < 0.001). Mean scores for 13 of the 15 satisfaction questions were significantly higher for Respimat® SMI than HFA-MDI (p < 0.05); in addition, the total score was also significantly higher for Respimat® SMI (p < 0.001). Most patients (217/224; 97%) were judged to have good technique with Respimat® SMI after 7 weeks’ use. Differences in efficacy measures between the devices were not significant.
Conclusion
These data indicated that a large majority of patients preferred Respimat® SMI to HFA-MDI.
Similar content being viewed by others
Notes
1 The use of trade names is for product identification purposes only and does not imply endorsement.
References
Hochrainer D, Hölz H. Comparison of the velocities of clouds delivered from Respimat® soft mist inhaler and metered dose inhalers [abstract]. J Aerosol Med 2001; 14(386): P1–5
Vincken W, Bantje T, Middle MV, et al. Long-term efficacy and safety of ipratropium bromide plus fenoterol via Respimat® Soft Mist™ inhaler (SMI) versus a pressurised metered dose inhaler in asthma. Clin Drug Invest 2004; 24: 17–28
Kilfeather SA, Ponitz HH, Beck E, et al. Improved delivery of ipratropium bromide/fenoterol from Respimat® Soft Mist™ inhaler in patients with COPD. Respir Med 2004; 98: 387–97
von Berg A, Jeena PM, Soemantri PA, et al. Efficacy and safety of ipratropium bromide plus fenoterol inhaled via Respimat® Soft Mist™ inhaler vs a conventional metered dose inhaler plus spacer in children with asthma. Pediatr Pulmonol 2004; 37: 264–72
Hufford MR, Shiffman S. Assessment methods for patient-reported outcomes. Dis Manage Health Outcomes 2003; 11: 77–86
Barry PW, O’Callaghan C. The influence of inhaler selection on efficacy of asthma therapies. Adv Drug Deliv Rev 2003; 55: 879–923
Kozma CM, Slaton TL, Monz BU, et al. Development and validation of a patient satisfaction and preference questionnaire for inhalation devices. Treat Respir Med 2005; 4(1): 41–52
Barczok M, Perleberg C, Kardos P, et al. Excellent satisfaction with Respimat® Soft Mist™ Inhaler in COPD patients [abstract]. Presented at VIII Deutsches Aerosol Therapie Seminar; 2003 Nov 14–15; Marburg
Sheth K, Bernstein JA, Lincourt WR, et al. Patient perceptions of an inhaled asthma medication administered as an inhalation powder via the Diskus or as an inhalation aerosol via a metered-dose inhaler. Ann Allergy Asthma Immunol 2003; 91: 55–60
Schlaeppi M, Edwards K, Fuller RW, et al. Patient perception of the Diskus inhaler: a comparison with the Turbuhaler inhaler. Br J Clin Pract 1996; 50: 14–9
Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J 2002; 19: 246–51
Erickson SR, Horton A, Kirking DM. Assessing metered-dose inhaler technique: comparison of observation vs patient self-report. J Asthma 1998; 35: 575–83
van Beerendonk I, Mesters I, Mudde AN, et al. Assessment of the inhalation technique in outpatients with asthma or chronic obstructive pulmonary disease using a metered-dose inhaler or dry powder device. J Asthma 1998; 35: 273–9
Acknowledgment
This study was funded by Boehringer Ingelheim. Petra Moroni is an employee of Boehringer Ingelheim. Dan Massey has worked as a consultant for Boehringer Ingelheim. Wolfgang Schurmann, Soren Schmidtmann and Mahmud Qidan are clinical investigators of this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schürmann, W., Schmidtmann, S., Moroni, P. et al. Respimat® Soft Mist™ Inhaler versus Hydrofluoroalkane Metered Dose Inhaler. Treat Respir Med 4, 53–61 (2005). https://doi.org/10.2165/00151829-200504010-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00151829-200504010-00006