Evidence map›Paper›PMID 26810934›Full record

Observational studyThe Journal of asthma : official journal of the Association for the Care of Asthma2016

Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting.

Janine A M Westerik, Victoria Carter, Henry Chrystyn, Anne Burden, Samantha L Thompson, Dermot Ryan, Kevin Gruffydd-Jones, John Haughney, Nicolas Roche, Federico Lavorini and 10 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of asthma : official journal of the Association for the Care of Asthma, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Interventions to improve inhaler technique for people with asthma.The Cochrane database of systematic reviews · 2017
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  14. The Nurse's Role in Educating Pediatric Patients on Correct Inhaler Technique: An Interventional Study.International journal of environmental research and public health · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Janine A M Westerika Research in Real-Life, Ltd , Cambridge , United Kingdom .
Victoria Carterb Optimum Patient Care Ltd , Cambridge , United Kingdom .
Henry Chrystyna Research in Real-Life, Ltd , Cambridge , United Kingdom .
Anne Burdena Research in Real-Life, Ltd , Cambridge , United Kingdom .
Samantha L Thompsona Research in Real-Life, Ltd , Cambridge , United Kingdom .
Dermot Ryand Woodbrook Medical Centre, Loughborough, United Kingdom, Centre for Population Health Sciences, University of Edinburgh , United Kingdom .
Kevin Gruffydd-Jonese Box Surgery , Box , United Kingdom .
John Haughneyf Academic Primary Care, University of Aberdeen , Aberdeen , United Kingdom .
Nicolas Rocheg University Paris Descartes (EA2511), Cochin Hospital Group (AP-HP) , Paris , France .
Federico Lavorinih Department of Experimental and Clinical Medicine , Careggi University Hospital , Florence , Italy .
Alberto Papii Department of Medical Sciences , University of Ferrara , Ferrara , Italy .
Antonio Infantinoj Special Interest Respiratory Area, Società Italiana Interdisciplinare per le Cure Primarie , Bari , Italy .
Miguel Roman-Rodriguezk Primary Care Respiratory Research Unit, Instituto de Investigación Sanitaria de Palma IdisPa , Palma de Mallorca , Spain .
Sinthia Bosnic-Anticevichl Sydney Medical School and the Woolcock Institute of Medical Research, University of Sydney , Sydney , Australia .
Karin Lisspersm Department of Public Health and Caring Sciences , Preventive Medicine and Family Medicine, Uppsala University , Uppsala , Sweden .
Björn Ställbergm Department of Public Health and Caring Sciences , Preventive Medicine and Family Medicine, Uppsala University , Uppsala , Sweden .
Svein Høegh Henrichsenn Department of General Medicine , University of Oslo and Langbølgen Legesenter , and.
Thys van der Moleno Department of Primary Care , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands.
Catherine Huttona Research in Real-Life, Ltd , Cambridge , United Kingdom .
David B Pricea Research in Real-Life, Ltd , Cambridge , United Kingdom .

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCorrect inhaler technique is central to effective delivery of asthma therapy. The study aim was to identify factors associated with serious inhaler technique errors and their prevalence among primary care patients with asthma using the Diskus dry powder inhaler (DPI).

methodsThis was a historical, multinational, cross-sectional study (2011-2013) using the iHARP database, an international initiative that includes patient- and healthcare provider-reported questionnaires from eight countries. Patients with asthma were observed for serious inhaler errors by trained healthcare providers as predefined by the iHARP steering committee. Multivariable logistic regression, stepwise reduced, was used to identify clinical characteristics and asthma-related outcomes associated with ≥1 serious errors.

resultsOf 3681 patients with asthma, 623 (17%) were using a Diskus (mean [SD] age, 51 [14]; 61% women). A total of 341 (55%) patients made ≥1 serious errors. The most common errors were the failure to exhale before inhalation, insufficient breath-hold at the end of inhalation, and inhalation that was not forceful from the start. Factors significantly associated with ≥1 serious errors included asthma-related hospitalization the previous year (odds ratio [OR] 2.07; 95% confidence interval [CI], 1.26-3.40); obesity (OR 1.75; 1.17-2.63); poor asthma control the previous 4 weeks (OR 1.57; 1.04-2.36); female sex (OR 1.51; 1.08-2.10); and no inhaler technique review during the previous year (OR 1.45; 1.04-2.02).

conclusionsPatients with evidence of poor asthma control should be targeted for a review of their inhaler technique even when using a device thought to have a low error rate.

Indexed as

Administration, InhalationAdultAgedAge FactorsAsthmaBody Mass IndexCross-Sectional StudiesDry Powder InhalersEducational StatusEquipment DesignFemaleHumansLogistic ModelsMaleMiddle AgedOdds RatioAsthma therapycross-sectionalDiskus inhalerinhalation devicesmultinational

Identifiers

PMID26810934
PMCPMC4819842

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.