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Improved metered dose inhaler technique when a coordination cap is used.

Wahida Azouz1, Jessica Campbell, John Stephenson

  • 11 Division of Pharmacy and Pharmaceutical Sciences, School of Applied Sciences, University of Huddersfield , Huddersfield, HD1 3DH, UK .

Journal of Aerosol Medicine and Pulmonary Drug Delivery
|July 11, 2013
PubMed
Summary

A new coordination cap (CAP) for metered dose inhalers (MDIs) significantly reduced fast inhalation flow rates and improved coordination. This MDI accessory, combined with instructions, helps patients achieve better inhaler technique.

Keywords:
I-Breatheasthmadeviceinhalation flow

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Area of Science:

  • Respiratory Medicine
  • Pharmacology
  • Biomedical Engineering

Background:

  • Metered dose inhalers (MDIs) are commonly used for respiratory conditions but present challenges for patients.
  • Key issues include poor inhalation-actuation coordination and excessively fast peak inspiratory flow (PIF).
  • These MDI usage errors can reduce medication delivery efficiency and treatment effectiveness.

Purpose of the Study:

  • To evaluate the efficacy of a novel coordination cap (CAP) in addressing MDI usage problems.
  • To determine if the CAP, with specific inhalation instructions, can improve patient coordination and reduce PIF.

Main Methods:

  • Inhalation profiles (PIF, TsIn, Vi, Ti) were measured in asthma patients using their standard MDI.
  • Measurements were repeated with the CAP attached (MDI+CAP).
  • Patients then received training to inhale for 5 seconds through the MDI+CAP (MDI+CAP+TRAIN), with profiles re-measured.

Main Results:

  • The MDI+CAP increased airflow resistance compared to the MDI alone.
  • Peak inspiratory flow (PIF) significantly decreased from 155.6 L/min (MDI) to 112.3 L/min (MDI+CAP) and 73.8 L/min (MDI+CAP+TRAIN).
  • Inhalation time (Ti) increased significantly, and the number of patients achieving slow flow technique rose substantially with the CAP and training.

Conclusions:

  • The coordination cap, by increasing resistance and guiding prolonged inhalation, effectively reduces peak inspiratory flow.
  • This intervention significantly improves MDI coordination and promotes a slower inhalation technique, enhancing usability.