Evidence map›Paper›PMID 29338792›Full record

SynthesisRespiratory research2018

Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes.

Omar Sharif Usmani, Federico Lavorini, Jonathan Marshall, William Christopher Nigel Dunlop, Louise Heron, Emily Farrington, Richard Dekhuijzen

3 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Respiratory research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 188 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
188citing papers in PubMed, 3 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.

NCT04203446 completednot on this mapstarted 2019, after this paper: background citation

Assessment of Clinical Factors Influencing on Correctness of Inhalation Technique in Adults With Asthma or COPD.

TypeobservationalSponsorMedical University of WarsawRan2019 to 2023Enrolled180ConditionsAsthma, COPDArmsAssessment of correctness of inhaling technique
NCT04349735 nacompletednot on this mapstarted 2019, after this paper: background citation

Comparison of Three Methods of Assessment of INhalation TECHnique in Patients With Asthma and COPD

TypeinterventionalSponsorMedical University of WarsawRan2019 to 2022Enrolled120ConditionsAsthma, COPDArmsAssessment of inhalation technique
NCT05664347 nacompletednot on this mapstarted 2020, after this paper: background citation

Video-based Teach-to-goal Intervention on Inhaler Technique on Adults With Asthma and COPD: a Randomized Controlled Trial

TypeinterventionalSponsorUniversity of JordanRan2020 to 2021Enrolled154ConditionsCOPD, Asthma, Inhaled Steroid Dependent AsthmaArmsVerbal teach to goal education, Video based teach to goal education
3 · Its place in the literature

Who cites it

188 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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128 more citing papers are in PubMed but not listed here.

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

7 authors.

Omar Sharif UsmaniAirway Disease, NHLI, Imperial College London & Royal Brompton Hospital, Dovehouse Street, London, SW3 6LY, UK. o.usmani@imperial.ac.uk.
Federico LavoriniDepartment of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy.
Jonathan MarshallMundipharma International Limited, Cambridge Science Park, Cambridge, CB4 0AB, UK.
William Christopher Nigel DunlopMundipharma International Limited, Cambridge Science Park, Cambridge, CB4 0AB, UK.
Louise HeronAdelphi Values, Adelphi Mill, Macclesfield, Cheshire, SK10 5JB, UK.
Emily FarringtonAdelphi Values, Adelphi Mill, Macclesfield, Cheshire, SK10 5JB, UK.
Richard DekhuijzenRadboud University Medical Center, Nijmegen, Netherlands.

Funding

Mundipharma International Ltd n/a
6 · The paper itself

Abstract

backgroundInhaled drug delivery is the cornerstone treatment for asthma and chronic obstructive pulmonary disease (COPD). However, use of inhaler devices can be challenging, potentially leading to critical errors in handling that can significantly reduce drug delivery to the lungs and effectiveness of treatment.

methodsA systematic review was conducted to define 'critical' errors and their impact on health outcomes and resource use between 2004 and 2016, using key search terms for inhaler errors in asthma and COPD (Search-1) and associated health-economic and patient burden (Search-2).

resultsSearch-1 identified 62 manuscripts, 47 abstracts, and 5 conference proceedings (n = 114 total). Search-2 identified 9 studies. We observed 299 descriptions of critical error. Age, education status, previous inhaler instruction, comorbidities and socioeconomic status were associated with worse handling error frequency. A significant association was found between inhaler errors and poor disease outcomes (exacerbations), and greater health-economic burden.

conclusionsWe have shown wide variations in how critical errors are defined, and the evidence shows an important association between inhaler errors and worsened health outcomes. Given the negative impact diminished disease outcomes impose on resource use, our findings highlight the importance of achieving optimal inhaler technique, and a need for a consensus on defining critical and non-critical errors.

Indexed as

Anti-Asthmatic AgentsAsthmaHumansMetered Dose InhalersNebulizers and VaporizersPulmonary Disease, Chronic ObstructiveTreatment OutcomeAnti-Asthmatic AgentsAdherenceAerosolsErrorsInhalersObstructive lung diseases

Identifiers

PMID29338792
PMCPMC5771074

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.