Opinion of pneumologists on the importance of inhalers in patients with asthma or COPD
Background: Medications for asthma and COPD are mainly used in the form of inhalations. A survey was performed to obtain the opinion of experts about the importance of inhalers in inhaled drug therapy.
Methods: All members–pulmonologists of the Slovenian Respiratory Society were invited to participate in the survey using a two-stage Delphi method. The result of each response were shown by the median and interquartile range, whereby we calculated the level of consensus.
Results: 176 doctors were invited. Most questions were answered by 49 (27.8 %) participants. In the second round 42 doctors responded. As many as 33 out of 41 respondents (80.5 %) felt that in the treatment of asthma and COPD the selection of medicines and inhalers are equally important. When choosing an inhaler, it is crucial that it is simple to instruct the patients about its use. Respondents highly agreed with the statement that patients should receive a prescription for inhaler only after they have been trained on how to use it. As appropriate persons for the training of patients on the use of inhalers the respondents recognized (from most to least suitable) pulmonologists, nurses, general practitioners or pharmacists. 53.8 % of respondents considered that the patient’s skill of the use of inhaler should be checked on every visit to the doctor. Respondents believed that replacing inhalers without consulting the treating doctor may result in incorrect use of the inhaler, poor patient compliance, more exacerbations of the disease and poorer disease control. Some consensus with an indiﬀerent median of 4.5 was reached with regard to the argument that the doctor should prescribe the inhaler that is the cheapest for society.
Conclusions: Slovenian pulmonologists believe that any change of inhaler is a critical event, which must be coordinated with the patient and the doctor.
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