Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study
Identifieur interne : 000B06 ( Pmc/Curation ); précédent : 000B05; suivant : 000B07Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study
Auteurs : Henry Chrystyn [Royaume-Uni] ; David B. Price [Royaume-Uni] ; Mathieu Molimard [France] ; John Haughney ; Sinthia Bosnic-Anticevich [Australie] ; Federico Lavorini [Italie] ; John Efthimiou [Royaume-Uni] ; Dawn Shan [Royaume-Uni] ; Erika Sims [Royaume-Uni] ; Anne Burden [Royaume-Uni] ; Catherine Hutton [Royaume-Uni] ; Nicolas Roche [France]Source :
- BMC Pulmonary Medicine [ 1471-2466 ] ; 2016.
Abstract
Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers.
Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder.
Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (
These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler.
ClinicalTrials.gov Identifier:
The online version of this article (doi:10.1186/s12890-016-0169-5) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12890-016-0169-5
PubMed: 26769482
PubMed Central: 4712500
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Henry Chrystyn<affiliation><nlm:aff id="Aff1">Inhalation Consultancy Ltd, Yeadon, Leeds, West Yorkshire UK</nlm:aff><wicri:noCountry code="subfield">West Yorkshire UK</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation><affiliation><nlm:aff id="Aff3">Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK</nlm:aff><wicri:noCountry code="subfield">AB25 2ZD UK</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK</nlm:aff><wicri:noCountry code="subfield">AB25 2ZD UK</wicri:noCountry></affiliation>Le document en format XML
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District, Sydney</wicri:regionArea></affiliation></author><author><name sortKey="Lavorini, Federico" sort="Lavorini, Federico" uniqKey="Lavorini F" first="Federico" last="Lavorini">Federico Lavorini</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence</wicri:regionArea></affiliation></author><author><name sortKey="Efthimiou, John" sort="Efthimiou, John" uniqKey="Efthimiou J" first="John" last="Efthimiou">John Efthimiou</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Horizon Respiratory Consultancy, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Horizon Respiratory Consultancy, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Shan, Dawn" sort="Shan, Dawn" uniqKey="Shan D" first="Dawn" last="Shan">Dawn Shan</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Sims, Erika" sort="Sims, Erika" uniqKey="Sims E" first="Erika" last="Sims">Erika Sims</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff8">Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich</wicri:regionArea></affiliation></author><author><name sortKey="Burden, Anne" sort="Burden, Anne" uniqKey="Burden A" first="Anne" last="Burden">Anne Burden</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Hutton, Catherine" sort="Hutton, Catherine" uniqKey="Hutton C" first="Catherine" last="Hutton">Catherine Hutton</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Roche, Nicolas" sort="Roche, Nicolas" uniqKey="Roche N" first="Nicolas" last="Roche">Nicolas Roche</name><affiliation wicri:level="1"><nlm:aff id="Aff9">University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26769482</idno><idno type="pmc">4712500</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712500</idno><idno type="RBID">PMC:4712500</idno><idno type="doi">10.1186/s12890-016-0169-5</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000B29</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000B29</idno><idno type="wicri:Area/Pmc/Curation">000B06</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000B06</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study</title><author><name sortKey="Chrystyn, Henry" sort="Chrystyn, Henry" uniqKey="Chrystyn H" first="Henry" last="Chrystyn">Henry Chrystyn</name><affiliation><nlm:aff id="Aff1">Inhalation Consultancy Ltd, Yeadon, Leeds, West Yorkshire UK</nlm:aff><wicri:noCountry code="subfield">West Yorkshire UK</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Price, David B" sort="Price, David B" uniqKey="Price D" first="David B." last="Price">David B. Price</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation><affiliation><nlm:aff id="Aff3">Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK</nlm:aff><wicri:noCountry code="subfield">AB25 2ZD UK</wicri:noCountry></affiliation></author><author><name sortKey="Molimard, Mathieu" sort="Molimard, Mathieu" uniqKey="Molimard M" first="Mathieu" last="Molimard">Mathieu Molimard</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Medical Pharmacology, CHU et Univ. de Bordeaux, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Medical Pharmacology, CHU et Univ. de Bordeaux, Bordeaux</wicri:regionArea></affiliation></author><author><name sortKey="Haughney, John" sort="Haughney, John" uniqKey="Haughney J" first="John" last="Haughney">John Haughney</name><affiliation><nlm:aff id="Aff3">Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK</nlm:aff><wicri:noCountry code="subfield">AB25 2ZD UK</wicri:noCountry></affiliation></author><author><name sortKey="Bosnic Anticevich, Sinthia" sort="Bosnic Anticevich, Sinthia" uniqKey="Bosnic Anticevich S" first="Sinthia" last="Bosnic-Anticevich">Sinthia Bosnic-Anticevich</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney and Sydney Local Health District, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney and Sydney Local Health District, Sydney</wicri:regionArea></affiliation></author><author><name sortKey="Lavorini, Federico" sort="Lavorini, Federico" uniqKey="Lavorini F" first="Federico" last="Lavorini">Federico Lavorini</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence</wicri:regionArea></affiliation></author><author><name sortKey="Efthimiou, John" sort="Efthimiou, John" uniqKey="Efthimiou J" first="John" last="Efthimiou">John Efthimiou</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Horizon Respiratory Consultancy, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Horizon Respiratory Consultancy, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Shan, Dawn" sort="Shan, Dawn" uniqKey="Shan D" first="Dawn" last="Shan">Dawn Shan</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Sims, Erika" sort="Sims, Erika" uniqKey="Sims E" first="Erika" last="Sims">Erika Sims</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff8">Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich</wicri:regionArea></affiliation></author><author><name sortKey="Burden, Anne" sort="Burden, Anne" uniqKey="Burden A" first="Anne" last="Burden">Anne Burden</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Hutton, Catherine" sort="Hutton, Catherine" uniqKey="Hutton C" first="Catherine" last="Hutton">Catherine Hutton</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Roche, Nicolas" sort="Roche, Nicolas" uniqKey="Roche N" first="Nicolas" last="Roche">Nicolas Roche</name><affiliation wicri:level="1"><nlm:aff id="Aff9">University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Pulmonary Medicine</title><idno type="eISSN">1471-2466</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers.</p></sec><sec><title>Methods</title><p>Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder.</p></sec><sec><title>Results</title><p>Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (<italic>n</italic> = 277) and Pulmojet-Turbohaler (<italic>n</italic> = 144) comparisons. Non-inferiority in the proportions of patients recording no nurse-observed serious errors was demonstrated for both Pulmojet versus Diskus, and Pulmojet versus Turbohaler; therefore, superiority was tested. Patients were significantly less likely to make ≥1 nurse-observed serious errors using Pulmojet compared with Diskus (odds ratio, 0.31; 95 % CI, 0.19–0.51) or Pulmojet compared with Turbohaler (0.23; 0.12–0.44) after reading the patient information leaflet with additional video instruction, if required.</p></sec><sec><title>Conclusions</title><p>These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler.</p></sec><sec><title>Trial registration</title><p>ClinicalTrials.gov Identifier: <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01794390">NCT01794390 </ext-link>(February 14, 2013)</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12890-016-0169-5) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Pulm Med</journal-id><journal-id journal-id-type="iso-abbrev">BMC Pulm Med</journal-id><journal-title-group><journal-title>BMC Pulmonary Medicine</journal-title></journal-title-group><issn pub-type="epub">1471-2466</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26769482</article-id><article-id pub-id-type="pmc">4712500</article-id><article-id pub-id-type="publisher-id">169</article-id><article-id pub-id-type="doi">10.1186/s12890-016-0169-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chrystyn</surname><given-names>Henry</given-names></name><address><email>h.chrystyn@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Price</surname><given-names>David B.</given-names></name><address><phone>+44 1223 967 855</phone><email>dprice@rirl.org</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Molimard</surname><given-names>Mathieu</given-names></name><address><email>Mathieu.Molimard@pharmaco.u-bordeaux2.fr</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Haughney</surname><given-names>John</given-names></name><address><email>john.haughney@btinternet.com</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Bosnic-Anticevich</surname><given-names>Sinthia</given-names></name><address><email>sinthia.bosnic-anticevich@sydney.edu.au</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Lavorini</surname><given-names>Federico</given-names></name><address><email>federico.lavorini@unifi.it</email></address><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Efthimiou</surname><given-names>John</given-names></name><address><email>johnefthimiou1@hotmail.co.uk</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Shan</surname><given-names>Dawn</given-names></name><address><email>xshanxshan@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Sims</surname><given-names>Erika</given-names></name><address><email>e.sims@uea.ac.uk</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff8"></xref></contrib><contrib contrib-type="author"><name><surname>Burden</surname><given-names>Anne</given-names></name><address><email>annie.burden1@btinternet.com</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Hutton</surname><given-names>Catherine</given-names></name><address><email>catherine@rirl.org</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Roche</surname><given-names>Nicolas</given-names></name><address><email>nicolas.roche@cch.aphp.fr</email></address><xref ref-type="aff" rid="Aff9"></xref></contrib><aff id="Aff1"><label></label>Inhalation Consultancy Ltd, Yeadon, Leeds, West Yorkshire UK</aff><aff id="Aff2"><label></label>Research in Real-Life, 5a Coles Lane, Oakington, Cambridge, UK</aff><aff id="Aff3"><label></label>Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK</aff><aff id="Aff4"><label></label>Department of Medical Pharmacology, CHU et Univ. de Bordeaux, Bordeaux, France</aff><aff id="Aff5"><label></label>Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney and Sydney Local Health District, Sydney, Australia</aff><aff id="Aff6"><label></label>Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy</aff><aff id="Aff7"><label></label>Horizon Respiratory Consultancy, Oxford, UK</aff><aff id="Aff8"><label></label>Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK</aff><aff id="Aff9"><label></label>University Paris Descartes (EA2511), Respiratory and Intensive Care Medicine Department, Cochin Hospital Group, AP-HP, Paris, France</aff></contrib-group><pub-date pub-type="epub"><day>14</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>14</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>16</volume><elocation-id>12</elocation-id><history><date date-type="received"><day>13</day><month>5</month><year>2015</year></date><date date-type="accepted"><day>5</day><month>1</month><year>2016</year></date></history><permissions><copyright-statement>© Chrystyn et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers.</p></sec><sec><title>Methods</title><p>Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder.</p></sec><sec><title>Results</title><p>Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (<italic>n</italic> = 277) and Pulmojet-Turbohaler (<italic>n</italic> = 144) comparisons. Non-inferiority in the proportions of patients recording no nurse-observed serious errors was demonstrated for both Pulmojet versus Diskus, and Pulmojet versus Turbohaler; therefore, superiority was tested. Patients were significantly less likely to make ≥1 nurse-observed serious errors using Pulmojet compared with Diskus (odds ratio, 0.31; 95 % CI, 0.19–0.51) or Pulmojet compared with Turbohaler (0.23; 0.12–0.44) after reading the patient information leaflet with additional video instruction, if required.</p></sec><sec><title>Conclusions</title><p>These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler.</p></sec><sec><title>Trial registration</title><p>ClinicalTrials.gov Identifier: <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01794390">NCT01794390 </ext-link>(February 14, 2013)</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12890-016-0169-5) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Asthma</kwd><kwd>Chronic obstructive pulmonary disease</kwd><kwd>Serious errors</kwd><kwd>Dry powder inhaler</kwd><kwd>Inhaler technique</kwd><kwd>Mastery</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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