Ventolin

PURPOSE: Current methods that require patients to track inhaler doses are unreliable and can lead to circumstances where medication is unavailable. This study examined patient satisfaction and handling performance of an MDI fitted with an integrated dose counter in 219 patients with COPD.

METHODS: Data were collected using self-report questionnaires that assessed previous MDI experience and overall satisfaction with the MDI with counter. Counter performance was assessed during a 30 or 50 day treatment period by measuring the discrepancies between the counter readings and the actuations reported on a subject recorded diary card.

RESULTS: At baseline 65% of the patients reported feeling anxious not knowing the amount of medication left in their inhaler. Fifty-seven percent reported assessing the remaining quantity by shaking the inhaler and 43% reported waiting until it was completely empty. After using fluticasone propionate/salmeterol HFA or albuterol HFA MDI with Counter, 93% of patients were satisfied with it based on its ease of use and convenience. Ninety-one percent felt that it would allow them to monitor their medication use while 93% agreed that the counter would help them avoid running out of medication. A total of 308 discrepancies between subject-reported use and counter readings occurred in 15,835 device handlings (31,667 MDI actuations), constituting a discrepancy rate of 0.97 discrepancies per 100 actuations. Fifty-two percent of the subjects reported no discrepancies. For subjects reporting a discrepancy, the majority (90%) were of 1 or 2 actuations.

CONCLUSION: These data support the need for a reliable, MDI actuation counting device and document the favorable patient perceptions of the MDI with Counter. The results showed a high level of concordance between the MDI with Counter and the subject-recorded diary card.

CLINICAL IMPLICATIONS: The addition of an integrated dose counter to an MDI will provide patients with a reliable indication of remaining actuations in their inhalers and increase clinicians' assurance that patients are not using their inhalers beyond the recommended number of labeled doses, a situation that clearly impacts patient health.

DISCLOSURE: Courtney Crim, Grant monies (from industry related sources) Study supported by a grant from GlaxoSmithkline; Employee All authors are employees of GlaxoSmithKline Inc.; Product/procedure/ technique that is considered research and is NOT yet approved for any purpose. MDI dose counter is approved for Ventolin HFA in the US and for Seretide in the UK

Courtney Crim MD * William R. Lincourt BS Nickolas W. Locantore PhD J. R. Carranza-Rosenzweig PharmD GlaxoSmithKline Inc., Raleigh, NC

COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group