Appropriate use of a dry powder inhaler based on inhalation flow pattern. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Kondo, Tetsuri; Hibino, Makoto; Tanigaki, Toshimori; Cassan, Stanley; Tajiri, Sakurako; Akazawa, Kenichro
• Is Part Of: Journal of pharmaceutical health care and sciences. Volume 3:Issue 1(2017)
• Page Start: 1
• Page End: 7
• Publication Date: 2017-12
• Subjects: Dry powder inhaler -- Instruction -- Inhalation flow profile -- Self-training; Clinical pharmacology -- Periodicals; 615.1
• DOI: 10.1186/s40780-017-0076-9
• Languages: English
• ISSNs: 2055-0294

Abstract

Abstract Background An optimal inhalation flow pattern is essential for effective use of a dry powder inhaler (DPI). We wondered whether DPI instructors inhale from a DPI with an appropriate pattern, and if not, whether self-training with visual feedback is effective. Methods Subjects were 14 pharmacists regularly engaged in instruction in DPI use. A newly designed handy inhalation flow visualizer (Visual Trainer: VT) was used to assess inhalation profiles and to assist in self-training. With a peak inhalation flow rate (PIFR) > 50 L/min, time reaching PIFR (TPF ) < 0.4 s, inhalation volume (VI ) > 1 L, and flow at 0.3 s after the onset of inhalation (F0.3 ) > 50 L/min, the pattern was considered optimal. Results Using Diskus or Turbuhaler 12 and 10 subjects respectively inhaled with a suitable PIFR. Those with a satisfactory F0.3 were 10 and 7 respectively. The TPF was short enough in only 1 and 2 respectively. All 14 subjects inhaled deeply (VI ) through Diskus, and 10 did so through Turbuhaler. In the self-training session, only 3 subjects satisfied all three variables at the first trial, while 2 or 3 trials were required in other subjects. Among the three variables, optimal TPF was the most difficult to attain. Once a satisfactory inhalation pattern was achieved using one DPI, eleven out of 12 subjects inhaled with a satisfactory pattern through the other DPI. Conclusion Visualization of the inhalation flow pattern facilitates the learning of proper inhalation technique through a DPI.