Observational studyInternational journal of chronic obstructive pulmonary disease2016
Inhalation errors due to device switch in patients with chronic obstructive pulmonary disease and asthma: critical health and economic issues.
Observational study in International journal of chronic obstructive pulmonary disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses 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
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- The Efficacy and Cost-Effectiveness of Umeclidinium/Vilanterol versus Tiotropium in Symptomatic Patients with Chronic Obstructive Pulmonary Disease.Canadian respiratory journal · 2022Pooled it
- Systematic review of association between critical errors in inhalation and health outcomes in asthma and COPD.NPJ primary care respiratory medicine · 2018Pooled it
- Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes.Respiratory research · 2018Pooled it
- Device use errors with soft mist inhalers: A global systematic literature review and meta-analysis.Chronic respiratory diseasePooled it
- Cost-effectiveness analysis of umeclidinium bromide/vilanterol 62.5/25 mcg versus tiotropium/olodaterol 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease: a Spanish National Healthcare System perspective.Respiratory research · 2018Trial
- Missed Opportunities in the Therapeutic Patterns of Chronic Obstructive Pulmonary Disease: A Real-World Italian Study on the Impact of Severe Exacerbation on Mortality and Hospital Re-admission.Clinical drug investigation · 2026Article
- Single-Inhaler Triple Therapy (SITT) for COPD: An Italian expert opinion paper on improving clinical outcomes and equity of therapeutic access.Multidisciplinary respiratory medicine · 2026Article
- Key factors for implementing inhaler regimen switches in respiratory diseases: international expert consensus generated using a modified nominal group technique (NGT).NPJ primary care respiratory medicine · 2026Article
- Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.International journal of chronic obstructive pulmonary disease · 2024Review
- Exploring General Practitioners' Preferences and Experience with Respiratory Inhaler Devices.Pulmonary therapy · 2022Article
- Suboptimal Peak Inspiratory Flow and Critical Inhalation Errors are Associated with Higher COPD-Related Healthcare Costs.International journal of chronic obstructive pulmonary disease · 2022Article
- Interventional, Quasi-Experimental Study of a Chronic Obstructive Pulmonary Disease Education Care Plan for Hospital Discharge.Pharmacy (Basel, Switzerland) · 2021Article
- Impact of PIF, Inhalation Technique and Medication Adherence on Health Status and Exacerbations in COPD: Protocol of a Real-World Observational Study (PIFotal COPD Study).Pulmonary therapy · 2021Article
- Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma: a narrative review of the clinical and economic case for smart inhalers.Journal of thoracic disease · 2021Review
- Health-care Resource Requirements and Potential Financial Consequences of an Environmentally Driven Switch in Respiratory Inhaler Use in England.Journal of health economics and outcomes research · 2021Article
- In Vitro Effect of Different Airflow Rates on the Aerosol Properties of Nebulized Glycopyrrolate in the eFlow® Closed System and Tiotropium Delivered in the HandiHaler®.Pulmonary therapy · 2020Article
- Asthma management with breath-triggered inhalers: innovation through design.Asthma research and practice · 2020Review
- The RespimatClinical drug investigation · 2019Review
- Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care.Nursing open · 2019Article
- Effect of Unintentional Storage and Handling Errors of Inhaled Medications: What Does This Mean for Therapeutic Equivalence Considerations?Journal of aerosol medicine and pulmonary drug delivery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferent inhalation devices are characterized by different techniques of use. The untrained switching of device in chronic obstructive pulmonary disease (COPD) and asthma patients may be associated with inadequate inhalation technique and, consequently, could lead to a reduction in adherence to treatment and limit control of the disease. The aim of this analysis was to estimate the potential economic impact related to errors in inhalation in patients switching device without adequate training.
methodsAn Italian real-practice study conducted in patients affected by COPD and asthma has shown an increase in health care resource consumption associated with misuse of inhalers. Particularly, significantly higher rates of hospitalizations, emergency room visits (ER), and pharmacological treatments (steroids and antimicrobials) were observed. In this analysis, those differences in resource consumption were monetized considering the Italian National Health Service (INHS) perspective.
resultsComparing a hypothetical cohort of 100 COPD patients with at least a critical error in inhalation vs 100 COPD patients without errors in inhalation, a yearly excess of 11.5 hospitalizations, 13 ER visits, 19.5 antimicrobial courses, and 47 corticosteroid courses for the first population were revealed. In the same way, considering 100 asthma patients with at least a critical error in inhalation vs 100 asthma patients without errors in inhalation, the first population is associated with a yearly excess of 19 hospitalizations, 26.5 ER visits, 4.5 antimicrobial courses, and 21.5 corticosteroid courses. These differences in resource consumption could be associated with an increase in health care expenditure for INHS, due to inhalation errors, of €23,444/yr in COPD and €44,104/yr in asthma for the considered cohorts of 100 patients.
conclusionThis evaluation highlights that misuse of inhaler devices, due to inadequate training or nonconsented switch of inhaled medications, is associated with a decrease in disease control and an increase in health care resource consumption and costs.
Indexed as
Identifiers
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.