The following is a summary of “Consideration and Assessment of Patient Factors When Selecting an Inhaled Delivery System in COPD,” published in the November 2023 issue of Pulmonology by Mahler et al. 

As recommendations and approaches for the pharmacological treatment of COPD concentrate on specific classes of inhaled medications, there is a need for information to guide healthcare professionals (HCPs) in selecting an inhaled medication delivery system that aligns with the unique characteristics of individual patients. 

For a study, researchers aimed to offer guidance on choosing an inhaled medication delivery system based on three crucial patient factors: cognitive function, manual dexterity/strength, and peak inspiratory flow (PIF). The study also includes details about specific tests for assessing these patient factors. Cognitive impairment, with an estimated prevalence of 25% among COPD patients, negatively impacts the correct use of handheld devices. While the prevalence of impaired manual dexterity/strength in COPD patients has not been explicitly reported, 79% of COPD patients have indicated one or more physical obstacles that could affect their ability to manipulate an inhaler device. Measuring PIF against the simulated resistance (r) of a dry powder inhaler (DPI) helps determine whether the patient can generate optimal turbulent energy within the device during inhalation.

Suboptimal PIFr for low to medium-high resistance DPIs has been noted in 19% to 84% of stable outpatients with COPD. When prescribing inhaled pharmacotherapy, HCPs should consider cognitive function, manual dexterity/strength, and PIFr in COPD patients. Impairments in these patient factors are prevalent in COPD, impacting the individual’s competence and effectiveness in using inhaled medications delivered through handheld devices.

Source: sciencedirect.com/science/article/abs/pii/S0012369223057069