ASTHMA UPDATE
MDI vs DPI: which is better for asthma control and treatment adherence?
Study evaluates patient satisfaction among MDI and DPI users
In patients with asthma, metered-dose inhalers (MDIs) are associated with better disease control and treatment adherence compared with dry-powder inhalers (DPIs), but both provide equivalent treatment satisfaction, according to a study published in the journal Respiratory Care.
Researchers evaluated 200 patients with asthma who were randomly assigned to receive either MDI (n=115) or DPI (n=85). Airway obstruction on spirometry, fraction of expired nitric oxide (FENO), and asthma control were evaluated between both the treatment groups. Treatment Satisfaction Questionnaire for Medication (TSQM) score was used to assess treatment satisfaction and Medication Adherence Questionnaire (MAQ) score was used to evaluate treatment adherence.
Of 200 patients, 49.0% of patients had an obstructive defect on spirometry and 19.0% of patients had fraction of expired nitric oxide levels (FENO) >25 parts per billion (ppb). More number of MDI users had well-controlled asthma vs DPI users (40.9% vs 17.6%; P=.001). MDI users had greater treatment adherence and better TSQM scores for Effectiveness (P=.004), Convenience (P=.02), and Global Satisfaction (P=.035) vs DPI users. MDI users had significantly better MAQ scores than DPI users (P= .043). TSQM scores were significantly correlated with MAQ scores (P<.05). No significant correlation was found between any TSQM score and pulmonary function or FENO concentration.
"Although the use of MDIs derived greater treatment satisfaction as compared to dry-powder inhalers, both devices offered equivalent treatment satisfaction after adjustment for clinical variables," the authors said.
References:
Aggarwal AN, Kumari R, Grover S. Patient Satisfaction With Inhaled Medication for Asthma. Respir Care. 2018 Mar 20 [Epub ahead of print]. doi: 10.4187/respcare.05544. PMID: 29559538