Consideration and Assessment of Patient Factors When Selecting an Inhaled Delivery System in COPD
Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved..
Because guidelines and strategies for pharmacologic treatment of COPD focus on specific classes of inhaled medications, there is an unmet need for information to guide health care professionals for selecting an inhaled medication delivery system that matches the unique characteristics of individual patients. This article provides guidance for selecting an inhaled medication delivery system based on three "key" patient factors: cognitive function, manual dexterity/strength, and peak inspiratory flow. In addition, information is provided about specific tests to assess these patient factors. Cognitive impairment with an estimated prevalence of 25% among patients with COPD adversely affects patients' ability to correctly use a handheld device. To our knowledge, the prevalence of impaired manual dexterity/strength has not been reported in those with COPD. However, 79% of patients with COPD have reported one or more physical impediments that could influence their ability to manipulate an inhaler device. The measurement of peak inspiratory flow against the simulated resistance (PIFr) of a dry powder inhaler establishes whether the patient has the inhalation ability for creating optimal turbulent energy within the device. A suboptimal PIFr for low to medium-high resistance dry powder inhalers has been reported in 19% to 84% of stable outpatients with COPD. Health care professionals should consider cognitive function, manual dexterity/strength, and PIFr in their patients with COPD when prescribing inhaled pharmacotherapy. Impairments in these patient factors are common among those with COPD and can affect the individual's competency and effectiveness of using inhaled medications delivered by handheld devices.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:165 |
|---|---|
| Enthalten in: |
Chest - 165(2024), 2 vom: 16. Feb., Seite 323-332 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mahler, Donald A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Bronchodilator Agents |
|---|
| Anmerkungen: |
Date Completed 14.02.2024 Date Revised 14.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.chest.2023.11.011 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM364688033 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM364688033 | ||
| 003 | DE-627 | ||
| 005 | 20240214232931.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.chest.2023.11.011 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1293.xml |
| 035 | |a (DE-627)NLM364688033 | ||
| 035 | |a (NLM)37977266 | ||
| 035 | |a (PII)S0012-3692(23)05706-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mahler, Donald A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Consideration and Assessment of Patient Factors When Selecting an Inhaled Delivery System in COPD |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.02.2024 | ||
| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Because guidelines and strategies for pharmacologic treatment of COPD focus on specific classes of inhaled medications, there is an unmet need for information to guide health care professionals for selecting an inhaled medication delivery system that matches the unique characteristics of individual patients. This article provides guidance for selecting an inhaled medication delivery system based on three "key" patient factors: cognitive function, manual dexterity/strength, and peak inspiratory flow. In addition, information is provided about specific tests to assess these patient factors. Cognitive impairment with an estimated prevalence of 25% among patients with COPD adversely affects patients' ability to correctly use a handheld device. To our knowledge, the prevalence of impaired manual dexterity/strength has not been reported in those with COPD. However, 79% of patients with COPD have reported one or more physical impediments that could influence their ability to manipulate an inhaler device. The measurement of peak inspiratory flow against the simulated resistance (PIFr) of a dry powder inhaler establishes whether the patient has the inhalation ability for creating optimal turbulent energy within the device. A suboptimal PIFr for low to medium-high resistance dry powder inhalers has been reported in 19% to 84% of stable outpatients with COPD. Health care professionals should consider cognitive function, manual dexterity/strength, and PIFr in their patients with COPD when prescribing inhaled pharmacotherapy. Impairments in these patient factors are common among those with COPD and can affect the individual's competency and effectiveness of using inhaled medications delivered by handheld devices | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a cognitive function | |
| 650 | 4 | |a inhaler competency | |
| 650 | 4 | |a manual dexterity and strength | |
| 650 | 4 | |a peak inspiratory flow | |
| 650 | 4 | |a prescribing inhaled pharmacotherapy | |
| 650 | 4 | |a shared decision-making | |
| 650 | 7 | |a Bronchodilator Agents |2 NLM | |
| 700 | 1 | |a Halpin, David M G |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Chest |d 1970 |g 165(2024), 2 vom: 16. Feb., Seite 323-332 |w (DE-627)NLM000002720 |x 1931-3543 |7 nnns |
| 773 | 1 | 8 | |g volume:165 |g year:2024 |g number:2 |g day:16 |g month:02 |g pages:323-332 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.chest.2023.11.011 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 165 |j 2024 |e 2 |b 16 |c 02 |h 323-332 | ||