To identify characteristics of dry powder inhalers (DPIs) considered
important by asthma and c
hronic obstructive pulmonary disease (COPD)
in order to select attributes and attribute-levels for a discrete choice experiment.
Qualitative data was collected from a literature review performed
to determine which inhaler attributes impact inhaler satisfaction and adherence
among asthma and COPD patients using DPIs. Focus groups with asthma and COPD
patients were conducted in France, with patients asked to cite and rate important
features of their inhaler. Qualitative analysis of the transcripts was performed
following International Society For Pharmacoeconomics and Outcomes Research
Results of the literature review revealed no overall
consensus on the importance of different inhaler attributes in relation to inhaler
satisfaction and adherence across studies. The most frequently reported attributes
were: overall ease-of-use, low inspiratory flow requirements, presence of a dosing
feedback mechanism, ergonomics of the inhaler mouthpiece, ease with which the
device can be kept hygienic and the ease with which the medicinal dose can be prepared. Four discussion groups were held, with thirty patients participating. Overall,
the degree to which the inhaler can optimise treatment convenience appeared
to be the most important attribute to patients. In agreement with results of the
literature review, patients also rated the following inhaler attributes as being important: size of the dose counter, ability to keep the mouthpiece hygienic, ergonomics
of the inhaler mouthpiece, presence of a dosing feedback mechanism, ease with
which a dose can be prepared, low inspiratory flow requirements.
Results of this study provide an insight inhaler attributes most valued by asthma
and COPD patients. Patients described their ideal inhaler to be small, with an ergonomic mouthpiece and an easy to use dose preparation mechanism, and providing
enough medicine for at least a month of treatment.