Acta Scientific Pharmacology

Research Article Volume 2 Issue 7

Rational Selection of Inhalation Devices in the Treatment of Asthma by Means of the System of Objectified Judgement Analysis

Johan Kooistra1, Esther Metting2, Richard Dekhuijzen3, Anne Leendertse4, Paul Hagedoorn5 and Robert Janknegt6*

1BENU Pharmacies, Maarssen, The Netherlands
2Epidemiologist/Behavioral Scientist, University Groningen, Faculty of Economics and Business and Medical Faculty, The Netherlands
3Pulmonologist, Radboud University Medical Center, Nijmegen, The Netherlands
4Clinical Pharmacist, Longfonds, Amersfoort, The Netherlands
5Sr. Technologist Inhalation, Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, The Netherlands
6Hospital Pharmacist, Clinical Pharmacologist Sittard, The Netherlands

*Corresponding Author: Robert Janknegt, Hospital Pharmacist, Clinical Pharmacologist Sittard, The Netherlands.

Received: June 03, 2021; Published: June 30, 2021

Abstract

Objectives: The large number of available medicines and devices makes it almost impossible to have sufficient knowledge of each individual medicine and device, especially for general practitioners. Reducing the number of medicines and devices, based on rational criteria, allows physicians and pharmacists to build experience with a more limited set of medicines and to standardise the inhalation instructions.

Methods: In this study inhalers are compared by means of the SOJA method. The following selection criteria were applied: uniformity in device, number of steps per inhalation, risk of errors, hygienic aspects, feedback mechanism, risk of inhalation with an empty inhaler.

Results: Substantial differences were seen in the overall scores, with the Turbuhaler device showing the highest score, followed by Nexthaler and Spiromax. Several devices require more or less identical techniques, such as Diskus and its “generics”: Dry powder inhaler Glenmark or the Neutec have been scored separately, resulting in a much lower score than the Diskus, because only the LABA/ICS combination is available in these devices, without an option of rescue therapy in the same device.

Conclusions: A substantial reduction of inhalers, combined with optimal and standardised instructions should improve the care of asthma patients.

Keywords: Inhaled Corticosteroids; Short Acting Beta Sympathicomimetics (SABA); Drug

References

  1. “GINA guideline” (2021).
  2. “NHG standaard astma bij volwassenen” (2021).
  3. Usmani OS., et al. “Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes”. Respiratory Research1 (2018): 10.
  4. Kocks JWH., et al. “Systematic review of association between critical errors in inhalation and health outcomes in asthma and COPD”. npj Primary Care Respiratory Medicine 1 (2018): 43.
  5. Janknegt R and Steenhoek A. “The System of Objectified Judgement Analysis. A tool in rational drug selection for formulary purposes”. Drugs 53 (1997): 550-562.
  6. Janknegt R., et al. “Rational selection of inhalation devices in the treatment of chronic obstructive pulmonary disease by means of the System of Objectified Judgement Analysis (SOJA)”. European Journal of Hospital Pharmacy (2020).
  7. Van der Palen J., et al. “A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices”. npj Primary Care Respiratory Medicine 26 (2016): 16079.
  8. Chrystyn H., et al. “Device errors in asthma and COPD: systematic literature review and meta-analysis”. npj Primary Care Respiratory Medicine 27 (2017): 22.
  9. Uematsu T., et al. “Evaluation of Hygiene in Dry Powder Steroid Drug Inhalers Used by Elderly Asthma Patients”. Yakugaku Zasshi 140 (2020): 789-798.
  10. Denyer J. “Adherence monitoring in drug delivery”. Expert Opinion on Drug Delivery 7 (2010): 1127-1131.
  11. Higham MA., et al. “Determination of the minimum dose of lactose drug carrier that can be sensed during inhalation”. British Journal of Clinical Pharmacology 40 (1995): 281-282.

Citation

Citation: Robert Janknegt., et al. “Rational Selection of Inhalation Devices in the Treatment of Asthma by Means of the System of Objectified Judgement Analysis".Acta Scientific Pharmacology 2.7 (2021): 23-38.

Copyright

Copyright: © 2020 Robert Janknegt., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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