Real-life inhalation therapy – inhaler performance and patient education matter

Optimal management of asthma and chronic obstructive pulmonary disease requires that the patient complies with inhaled drug
treatments and that there is a successful interaction between the patient and the inhaler during the inhalation process. To ensure that
these occur, the performance of the inhaler, tolerability and effectiveness, ease of use and patient preference are important issues. In
addition to these, it is important to consider the overall cost of healthcare delivery using the prescribed inhaler. Patient-related factors with
the use of dry powder inhalers (DPIs) include dose preparation and the ability to use the recommended inhalation manoeuvre. An inhaler
meeting all the above criteria would be considered to be a ‘real-life inhaler’ and thus should ensure that the prescribed dose is efficiently
and evenly deposited in the airways during every inhalation process. DPIs have their own patient use problems and thus each type should
be considered with respect to the criteria described above. A ‘real-life inhaler’ is one that a patient can and will use that can be integrated
into a healthcare programme and provide significant benefits. It is important to consider the real-life criteria with respect to any device. In
this review we will consider these criteria with respect to Easyhaler®, a range of DPIs that is preferred by most, but not all, patients. The
review examines the economic consequences of effective inhaler use as well as the scientific and lung deposition characteristics of
the emitted dose with respect to patient use by all groups. The issues of inhalation flow-dependent dose emission, which occurs with all
DPIs, together with patient acceptability and compliance are all presented with reference to the Easyhaler and other DPIs.