J Korean Med Sci.  2022 Nov;37(46):e327. 10.3346/jkms.2022.37.e327.

Assessment of Inhaler Satisfaction and Determinants of High Satisfaction Among Korean COPD Patients

• Jang JG
• Lee KH
• Chung JH
• Shin KC
• Choi EY
• Jin HJ
• Ahn JH

• KMID: 2536134
• DOI: http://doi.org/10.3346/jkms.2022.37.e327

Abstract

Background
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) recommend considering patient preference when choosing an inhaler device. However, few studies have assessed both inhaler satisfaction and factors associated with high inhaler satisfaction. Therefore, we assessed inhaler satisfaction and determinants of high satisfaction in Korean COPD patients.
Methods
COPD patients were prospectively enrolled from January 2018 to November 2019. The 308 inhalers used by the 261 participants in this study included dry powder inhalers (Turbuhaler, Breezhaler, Ellipta, Diskus, and Genuair), a soft mist inhaler (Respimat), and pressurized metered dose inhalers (pMDIs). Inhaler satisfaction was assessed by the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire. High inhaler satisfaction was defined as an FSI-10 ≥ 43.
Results
Among 261 COPD patients, 163 (62.5%) were highly satisfied with their inhaler device. The rates of high inhaler satisfaction for Turbuhaler, Breezhaler, Ellipta, Diskus, Genuair, Respimat, and pMDI usage were 40.0%, 67.2%, 66.7%, 50.0%, 55.6%, 63.4%, and 45.0%, respectively (P = 0.215). In univariate analyses, higher body mass index, non-current smoker, GOLD grades I and II, a modified Medical Research Council (mMRC) score < 2, lower inhaler puff burden, once daily usage of inhaler, and good inhaler adherence were associated with high inhaler satisfaction. In multivariate analyses, an mMRC score < 2, and good inhaler adherence were independently associated with high inhaler satisfaction.
Conclusion
High inhaler satisfaction was associated with dyspnea symptom and good inhaler adherence in COPD patients. Effective strategies are needed including appropriate inhaler device selection, consideration of patient preference, and repeated inhaler education to improve patient satisfaction of inhalers.

Keyword

Chronic Obstructive Pulmonary Disease; Inhaler; Satisfaction; Dyspnea

Figure

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  Fig. 1 Study flow diagram.COPD = chronic obstructive pulmonary disease.

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  Fig. 2 Inhaler satisfaction according to inhaler type. (A) FSI-10 score according to inhaler type. (B) Proportions of respondents with high satisfaction according to inhaler type.FSI-10 = Feeling of Satisfaction with Inhaler questionnaire, pMDI = pressurized metered dose inhaler.

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  Fig. 3 Rates of high satisfaction according to mMRC score and inhaler adherence.mMRC = modified Medical Research Council.

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