Inhaler Misuse is Rampant in COPD

When patients don’t get enough training on how to use inhaler devices they have less control of chronic obstructive pulmonary disease (COPD). That leads to more healthcare consumption and cost, Italian researchers found. That risk of misuse is higher when patients switch inhalers.

The study was conducted by Alessandro Roggeri of ProCure Solutions in Bergamo, Italy, and colleagues, and was published in the International Journal of Chronic Obstructive Pulmonary Disease on March 21, 2016.

The authors state, “The aim of this analysis was to estimate the potential economic impact related to errors in inhalation in patients switching device without adequate training.” Since asthma and COPD often go hand-in-hand, and previous studies have shown that as many as 80% of asthma patients do not properly use their inhalers, the researchers investigated the issue of incorrect inhaler use among COPD patients.

In order to discover the cost associated with incorrect inhaler use, the researchers used data from a 2008 study (the GENEBI Project) which, they said, “investigated the prevalence of inhaler misuse and health care resource consumption in a large population of adult patients experienced in the use of inhalers which referred to chest clinics throughout Italy.”

There were 1,664 patients in enrolled. The researchers in the GENEBI Project found that patients who made critical inhalation technique errors used more healthcare resources when compared to patients without errors.

The researchers say, “For the aim of the present analysis, these differences in resource consumption were monetized from the INHS perspective by multiplying the differences in average resource consumption for their unitary cost in charge to INHS.”

They compared 100 COPD patients who made critical inhalation errors with 100 patients who did not make any inhalation errors. “The first population,” they report, “was associated with 11.5 hospitalizations, 13 ER visits, 19.5 antimicrobial courses, and 47 corticosteroids courses.”

The greatest difference between the COPD patients with errors and those without were related to hospitalizations (78% of the difference) and ER visits (20% of the difference).

They also note that different inhaling devices require different techniques, so switching devices without training can lead to worsening of the disease.

The researchers conclude that it is “crucial to consider all relevant costs, including those related to training sessions, additional consultations, repeated prescriptions, and management of acute events: these costs may contribute to reduce the potential benefit coming from switching inhalers.