Ref. | Disease | Subjects n | Design and treatment duration | Comparator and drugs used | Assessments | Clinical outcome | Diskus®* preferred? |
[4] | COPD | 156 | Single visit, interview and handling, never inhaled | HandiHaler®# | Questionnaire (17 items), technique | None | Yes (67%) |
[5] | Asthma | 159 | Single visit, interview and demonstration, never inhaled | TurbuhalerTM¶ | Asked about preference and inhaler attributes | None | Yes (65%) |
[6] | Asthma and COPD | 169 | Single visit, interview and demonstration, inhaled | TurbuhalerTM¶, placebo (?) | Rating (10-point scale) + preference questions, technique score | None | Yes (60%) |
[7] | Asthma | 145 | Cross-over, 3 weeks | pMDI, FP | Questionnaire (5 items), technique | Diary, PEF, rescue medications (compliance better with Diskus®*) | Yes (60%) |
[8] | Asthma and COPD | 50 | Single visit, sequential comparison, 1 puff only | TurbuhalerTM¶, placebo (?) | Questionnaire (17 items; Likert scale, overall preference), technique score | None (fewer crucial technique errors with Diskus®*) | No (34% versus 50% for TurbuhalerTM¶) |
[9] | OLD | 263 | Parallel group, double dummy, 4 weeks | TurbuhalerTM¶ (TER) versus Diskus®* (SLM) | Questionnaire (9 items) | PEF, rescue medications, symptoms, technique | Yes (98% versus 72% TurbuhalerTM¶) |
[10] | Asthma | 364 | Parallel group, 12 weeks | DiskhalerTM+, FP | Questionnaire (3 items), technique | FEV1, PEF, symptoms | Yes (64%; performance better with DiskhalerTM+) |
[11] | Asthma | 213 | Parallel group, double dummy (and placebo arm), 12 weeks | DiskhalerTM+, FP | Questionnaire (Likert scale) | Not described | Yes (61% versus 25% DiskhalerTM+) |
[12] | Asthma | 48 | Treatment switch, 4 weeks (pMDI for 3 previous months) | pMDI (SLB) versus Diskus®* (SLM) | Questionnaire (14 items), technique score | None | Yes (71%) |
[13] | Asthma | 380 | Parallel group, double dummy, 4 weeks | DiskhalerTM+, SLM | Technique, preference choice | PEF, rescue medications, symptoms | Yes (73%) |
Studies were sponsored by GlaxoSmithKline. COPD: chronic obstructive pulmonary disease; OLD: obstructive lung disease; pMDI: pressurised metered-dose inhaler; FP: fluticasone propionate; PEF: peak expiratory flow; TER: terbutaline; SLM: salmeterol; FEV1: forced expiratory volume in one second; SLB: salbutamol. ?: not clear from published paper; *: manufactured by GlaxoSmithKline, Brentford, UK; #: manufactured by Boehringer Ingelheim GmbH & Co. KG, Ingelheim, Germany; ¶: manufactured by AstraZeneca, Lund, Sweden; +: manufactured by GlaxoSmithKline.