ArticleJournal of asthma and allergy2011
Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD.
Article in Journal of asthma and allergy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Beclometasone for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2013Pooled it
- Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial.Respiratory research · 2018Trial
- Inhaler device technique can be improved in older adults through tailored education: findings from a randomised controlled trial.NPJ primary care respiratory medicine · 2014Trial
- Inhaler competence and patient satisfaction with Easyhaler®: results of two real-life multicentre studies in asthma and COPD.Drugs in R&D · 2013Trial
- Advanced Spray-Dried Cyanidin Chloride Inhalable Dry Powders with High Aerosol Dispersion Performance and Mitochondrial Bioenergetics Modulation for Targeted Pulmonary Delivery.ACS pharmacology & translational science · 2026Article
- Article
- Environmental impact of inhaled medicines: A Thoracic Society of Australia and New Zealand position statement.Respirology (Carlton, Vic.) · 2025Review
- Impact of Pharmacist-Led Intervention on Adherence to Inhalers, Inhalation Technique, and Disease Control Among Asthma/COPD Patients in a Resource Limited Center: An Interventional Study.Patient preference and adherence · 2024Article
- Local variation in low carbon footprint inhalers in pre-COVID pandemic primary care prescribing guidelines for adult asthma in England and its potential impact.British journal of clinical pharmacology · 2022Review
- Inhaler Devices in a Geriatric Patient Population: A Prospective Cross-Sectional Study on Patient Preferences.Patient preference and adherence · 2020Article
- Inhaled Corticosteroid Treatment Regimens and Health Outcomes in a UK COPD Population Study.International journal of chronic obstructive pulmonary disease · 2020Article
- Asthma: A Loss of Post-natal Homeostatic Control of Airways Smooth Muscle With Regression Toward a Pre-natal State.Frontiers in pediatrics · 2020Review
- Asthma management with breath-triggered inhalers: innovation through design.Asthma research and practice · 2020Review
- Article
- The REal Life EVidence AssessmeNt Tool (RELEVANT): development of a novel quality assurance asset to rate observational comparative effectiveness research studies.Clinical and translational allergy · 2019Article
- Quality standards in respiratory real-life effectiveness research: the REal Life EVidence AssessmeNt Tool (RELEVANT): report from the Respiratory Effectiveness Group-European Academy of Allergy and Clinical Immunology Task Force.Clinical and translational allergy · 2019Article
- Article
- Matching Inhaler Devices with Patients: The Role of the Primary Care Physician.Canadian respiratory journal · 2018Review
- COPD: the patient perspective.International journal of chronic obstructive pulmonary disease · 2016Review
- Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm.Primary care respiratory journal : journal of the General Practice Airways Group · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeResults of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS) in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI), breath-actuated MDI (BAI), and dry powder inhaler (DPI). PATIENTS AND
methodsThis retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5-60 years prescribed their first ICS (initiation population) by pMDI (n = 39,746), BAI (n = 9809), or DPI (n = 6792), or their first ICS dose increase (step-up population) by pMDI (n = 6245), BAI (n = 1388), or DPI (n = 1536). Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids). Outcomes were adjusted for potential confounding factors identified during a baseline year.
resultsIn the initiation population, adjusted odds ratios (95% confidence intervals [CI]) for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02-1.14]) and DPIs (1.13 [1.06-1.21]), while adjusted exacerbation rate ratios (95% CI) were 1.00 (0.93-1.08) and 0.88 (0.81-0.95), respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05-1.39) for BAIs and 1.13 (0.99-1.29) for DPIs; adjusted exacerbation rate ratios were 0.83 (0.71-0.98) for BAIs and 0.85 (0.74-0.98) for DPIs, compared with pMDIs.
conclusionInhaler device selection may have a bearing on clinical outcomes. Differences in real-world effectiveness among these devices require closer evaluation in well-designed prospective trials.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.