Mar 1, 2014 - tion, U.S. National Library of Medicine (PubMed) database for publications .... participating in RCTs receive more training in inhalation technique and .... technician, at additional study visits or by utilising tech- nologies such as ...
Respiratory Medicine (2014) 108, 694e700
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/rmed
Guidance on handheld inhalers in asthma and COPD guidelines P.N. Richard Dekhuijzen a,*, Leif Bjermer b, Federico Lavorini c, Vincent Ninane d, Mathieu Molimard e, John Haughney f a Department of Pulmonary Diseases (454), Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands b Department of Respiratory Medicine, Lund University Hospital, SE-22185 Lund, Sweden c Department of Experimental and Clinical Medicine, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy d Service de Pneumologie, Saint-Pierre University Hospital Brussels, 322 rue Haute, B-1000 Brussels, Belgium e University of Bordeaux, INSERM U657, 33076 Bordeaux Cedex, France f Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, AB25 2AY Scotland, UK
Received 18 November 2013; accepted 21 February 2014
Available online 1 March 2014
KEYWORDS Dry powder inhalers; Pressurised metereddose inhalers; Asthma; Chronic obstructive pulmonary disease; Guidelines
Summary Background: Inhaled therapy is the cornerstone of pharmacotherapy in patients with asthma and chronic obstructive pulmonary disease (COPD). Appropriate inhalation device selection is as important as drug choice but device-specific guidance appears to be lacking. Methods: To quantify the level of inhalation-device recommendations in clinical guidelines, a review was conducted by hand-searching national and international asthma and COPD guidelines (Global Initiative for Asthma [GINA] and Global initiative for chronic Obstructive Lung Disease [GOLD] guidelines) and an international guideline on device selection (the American College of Chest Physicians/American College of Asthma, Allergy, and Immunology [ACCP/ ACAAI]). For each guideline, the number of pages, tables/figures and references relating to inhalation devices was identified. Results: GINA and GOLD guidelines contain very little inhalation device-specific guidance beyond recommendations for demonstrating and testing correct inhalation technique:
