Effect of Replacing Inhalation Devices on Medication Adherence

In the treatment of respiratory diseases, the skill and adherence to inhaler device use are very important. Therefore, frequent replacements of devices that patients are accustomed to are not recommended due to concerns that it may disrupt adherence. The purpose of the study is to determine the frequency of inhaler device replacement, the reasons for replacement, and to evaluate inhaler adherence and usage skills after replacement.

Patients who had been receiving inhaler treatment for at least 1 year due to chronic respiratory diseases (COPD and asthma) were consecutively included in the study. Patients' inhaler device satisfaction, skill status, device education status, and whether their devices were changed were noted.

A total of 260 patients were included in the study. Thirty-one patients (11.9%) stated that they did not receive device training, and 40 patients (15.4%) stated that they received insufficient training. Device replacement had been performed in 158 patients (60.8%). 138 (87.3%) of the patients whose devices were changed were satisfied with their new devices. The most common reason for the change was that the patient wanted the change (54/34.2%). In 45 of the patients, the change was made without any explanation (28.4%). In 27 patients (17.1%), the replacement had been made because the formulation needed to be replaced. In 17 patients (10.8%), the device had been replaced due to side effects of the old device, and in 15 patients (9.5%), the device had been replaced because they could not use the device with the correct technique. Device usage skills were found to be better in the group whose devices were replaced than in the group whose devices were not replaced. (p = 0.04).

Our findings suggest that device replacement seems to be a good option for patients who are not satisfied with their device. Although frequent device replacement is not recommended, it may be useful for patients with insufficient prior education, as the new device will provide a new training opportunity.