Moving from CFC Aerosol to HFA Aerosol or Dry Powder Inhalers: What Do Patients Think?

• Published in: Respiration Vol. 69; no. 4; pp. 314 - 319
• Main Authors: Hartung, Thomas K., Allbutt, Helen, Dewar, Maria, Innes, J. Alastair, Crompton, Graham K.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 2002; S. Karger AG
• Subjects: Adolescent; Adult; Aerosol Propellants; Aged; Aged, 80 and over; Biological and medical sciences; Chlorofluorocarbons; Clinical Investigations; Equipment Design; Female; Humans; Hydrocarbons, Fluorinated; Male; Medical sciences; Middle Aged; Nebulizers and Vaporizers; Patient Satisfaction; Pharmacology. Drug treatments; Respiratory system; Dry powder inhalers; Chlorofluorocarbons; Hydrofluoroalkanes; Preference; Pressurised metered-dose inhalers; Acceptability; Human; Drug; Lung disease; Modification; Respiratory disease; Treatment efficiency; Psychological effect; Route of administration; Propellent; Chemotherapy; Treatment; Inhaler; Bronchus disease; Obstructive pulmonary disease; Patient position
• ISSN: 0025-7931; 1423-0356
• DOI: 10.1159/000063276

Background/Objectives: Environmentally friendly hydrofluoroalkane (HFA) pressurised metered-dose inhalers are currently being marketed to replace chlorofluorocarbon (CFC)-driven devices. It is uncertain whether these new formulations with different properties are acceptable to patients. Similarly, switching a patient to a dry powder inhaler (DPI) carries the risk of non-acceptance. Methods: One hundred patients with obstructive airway disease on regular CFC aerosol inhaler medication underwent a standardised, structured interview. During the interview patients were asked to use a new HFA aerosol inhaler and three DPIs in random order. Patients’ notions were recorded. Results: Most patients (96) agreed to change from their CFC to the HFA inhaler, of those, only 12 did so with some reservation. Properties (taste, user-friendliness, design) of the HFA inhaler were rated favourably. DPIs represented an acceptable alternative to aerosol inhalers. In fact, 57 patients preferred a DPI over the HFA inhaler. Not all powder devices were equally acceptable. Replacing the CFC inhaler with patients’ preferred alternative devices resulted in a more than 3-fold increase in costs. Conclusion: Concerns about the acceptability of reformulated CFC-free aerosol inhalers are ill founded. However, if given the choice, many patients prefer a DPI over the HFA inhaler. The transition offers an opportunity to review patients’ current treatment and the proficiency of their inhaling technique. Moving to CFC-free inhalers will have revenue implications.