Observational studyBMJ open respiratory research2025
Assessment of peak inspiratory flow in patients with chronic obstructive pulmonary disease: a multicentre, observational, prospective, real-life study.
Observational study in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04606394 (Peak Inspiratory Flow), which is not on this map. Cited by 2 papers.
What it found
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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.
Peak Inspiratory Flow (PIF) and Dry Powder Inhaler (DPI) Performance in Chronic Obstructive Pulmonary Disease (COPD)
Who cites it
2 citing papers in PubMed.
- Peak Inspiratory Flow Capability for Simulated Dry Powder Inhaler Resistances in Asthma Patients Prescribed Pressurized Metered-Dose Inhalers with Valved Holding Chambers: The USE-DPI Study.Journal of clinical medicine · 2026Article
- Changes in device-matched peak inspiratory flow after bedside inhaler coaching and factors associated with residual suboptimal flow: a retrospective observational study.Frontiers in pharmacology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with chronic obstructive pulmonary disease (COPD) use dry powder inhalers (DPIs) for disease management. DPI effectiveness relies on the patient's peak inspiratory flow (PIF), which may not always be optimal. We conducted an observational multicentre, prospective, real-life cohort study to determine the prevalence of suboptimal PIF in patients with COPD.
methods415 participants (11%, n=47 women, mean age=70±8.7 years, mean forced expiratory volume in 1 s (predicted %)=48.1%) recruited from 17 international centres had baseline PIF recorded with an In-Check Dial device at three resistance levels: (1) low, (2) high and (3) the participant's maintenance device. We also recorded PIF from participants as they would do at home to verify their proper inhalation technique. Participants underwent spirometry and completed questionnaires (COPD Assessment Test (CAT), Test of Adherence to Inhalers (TAI)-12).
resultsOf the 415 participants, 18% of DPI users (n=75) exhibited suboptimal values of PIF (as typical PIF <than what was required for tested inhalers in the study) when evaluated across DPI resistance groups ranging from low (R1) to high (R5) resistance, compared with 14% of participants (n=60) using devices without resistance (R0). Additionally, 14% of study participants were incapable of producing an optimal PIF or unwilling to do so (27%), impacting medication effectiveness. Participants with suboptimal PIF values had higher mean total CAT score (17.7±7) compared with those with optimal PIF values (12.1±7.6). When assessed globally, 37% (n=56) of participants with suboptimal PIF values did not adhere to treatment, highlighting the need for improved patient education and support.
conclusionSuboptimal PIF is common in COPD, requiring regular assessment and tailored inhalers. TRIAL REGISTRATION NUMBER: NCT04606394. Encepp EUPAS34689.
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