INTRODUCTION

In the management of chronic obstructive pulmonary disease (COPD), achieving sustained bronchodilation through the regular use of long-acting bronchodilators is currently the best treatment option for symptomatic patients. Delivery of these drugs via inhalation therefore needs to be adequate and reliable to maximise the benefits of such treatment. However, current treatment guidelines contain little advice on the key elements of inhalation therapy; namely, delivery devices and their performance in COPD, approaching inhaler selection, methods for improving compliance and the impact of patient preference on drug delivery and treatment outcomes.

To explore this topic in more detail, a Round Table meeting, sponsored by Boehringer Ingelheim GmbH, was held in Zürich, Switzerland, on 3–4 June 2005. The papers in this Review arise from the proceedings of that meeting. Our purpose was to consider the subject of inhaler use and selection in COPD, and how compliance and treatment outcomes might be improved by taking patient preference into account. Our discussion was broken down into the following categories: patient needs and medication styles [1]; communication between patient and doctor [2]; adherence to therapy [3]; advantages and disadvantages of the main types of inhaler devices and how they affect technique [4]; assessment of device preference and satisfaction [5]; and the role of the caregiver in choosing the inhaler device [6]. A summary of the points from each paper is provided below.