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P223 The patient’s role in the choice of new inhaler devices and dosing regimens for asthma and copd: a preference study
  1. T Robinson
  1. Harrogate and District NHS Foundation Trust, Harrogate, UK

Abstract

Introduction Management guidelines for asthma and COPD guide which inhaled therapies should be prescribed, but not what type of device. There appears to be little evidence in the literature to support if patient involvement influences how concordant patients are with inhaled therapies.

Aims and objectives The aim was for patients to rate inhaler devices and dosing regimens so that discreet choices could be made when adding new drugs and devices to the local joint primary and secondary care prescribing formulary.

Methods 40 patients with asthma (n = 20) or COPD were purposively selected to participate in the study. 30 patients were seen on a one to one basis and ten patients with COPD seen in a patient education group. They were each given devices not normally prescribed in the locality (asthma = 5, COPD = 6). They were given 2 sets of instructions on how to load and use each device, a patient information leaflet (PIL) produced by the manufacturer, and one designed by the local nursing team. Each patient was asked to complete a 5-point questionnaire. Questions included:

  • Which device did they prefer the most

  • Which device did they least prefer

  • Would they like once daily or twice daily maintenance medication

  • Would they like all their drugs in one type of device or different devices

  • Did they prefer the manufacturers PIL or the locally devised one

Results Preloaded devices were much preferred by both patient groups, although only 2 of the 6 devices needed loading. Once daily dosing regimens were preferred over twice daily dosing (N = 28). Patients comprehensively preferred the local instructions for use compared to the PIL (N = 38). Patients preferred to have the same device for all their inhaled therapies (N = 32).

Conclusions Most new drug delivery systems prescribed to patients are selected by clinicians. This small-scale study highlighted the importance of patient involvement when clinicians prescribe devices and dosing regimens. Manufacturers need to look at simplifying PILs, which may increase patients’ ability to use their device correctly.

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