Volume 97, Issue 1, Pages 12-19 (January 2003)

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ABSTRACT

ABSTRACT + REFS

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Improvement of asthma control with a breath-actuated pressurised metred dose inhaler (BAI): a prescribing claims study of 5556 patients using a traditional pressurised metred dose inhaler (MDI) or a breath-actuated device

Received 1 March 2002; accepted 3 July 2002.

Abstract

A relationship has been reported between sub-optimal inhaler technique and control of asthma symptoms. Randomised controlled trials and systematic reviews may fail to accurately represent this relationship, by excluding patients who are unable to correctly use the reviewed devices. Breath actuated inhalers (BAIs) are reported to be easier to use than metered dose inhalers (MDIs). This study uses a large primary care medical record database (DIN-LINK) to examine the ‘real-life’ clinical effectiveness of a BAI vs. traditional MDIs. A comparison is made between the quantity of asthma-related medication (β2 agonist, oral steroids and antibiotics) and healthcare resource use required by children (0–12 years) and adults (13+ years) using either the BAI or an MDI over a 12-month period. Out of 5556 new asthma patients who met the inclusion criteria, 306 used a BAI and 5250 used a traditional MDI. Children and adults using the BAI received fewer prescriptions for all three medication types than those using a traditional MDI (children:β2 agonists −18% P=0.036, oral steroids −88% P<0.05, antibiotics –68% P<0.05 and adults: β2 agonists −10.9%P =0.179, oral steroids −51.2% P<0.05, antibiotics −19.5%P =0.276). All prescription results reached statistical significance, with the exception ofβ2 agonist and antibiotic prescription numbers for adult patients. Children and adults using the BAI required less GP consultations for asthma (children −30.3%, P<0.05 and adults −22.9%,P <0.05) and less GP consultations for respiratory infections than those using a traditional MDI (children −35.2%, P -0.001 and adults −10.4%, P=0.236). Adults using the BAI required less outpatient appointments than adults using an MDI (−43.7%, P=0.166). All non-prescription resource results reached statistical significance with the exception of GP consultations for respiratory infections and outpatient visits in the adult group. In conclusion, children and adults using the BAI appear to have better asthma control than children and adults using an MDI as evidenced by fewer relief medication prescriptions and less healthcare resource use.

Keywords: inhaler, asthma, breath-actuated, beclomethasone, β2 agonists, salbutamol, control, resource use, Easi-Breathe®

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Article Outline

• Abstract

• References

• Copyright

References

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a Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, AB25 2AY, U.K.

b Abacus International, Bicester, Oxon, U.K.

c IVAX Pharmaceuticals UK Ltd. Albert Basin, Royal Docks, London, U.K.

f1 Correspondence should be addressed to: David Price, General Practice Airways Group Professor of Primary Care Respiratory Medicine, Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, U.K. Fax: +44 1224 550683; E-mail: d.price@abdn.ac.uk

PII: S0954-6111(02)91426-5

doi:10.1053/rmed.2002.1426

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