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Background: Although inhaled medications are effective therapies for COPD, many patients and providers use them incorrectly.
Methods: We recruited providers who prescribe inhalers or teach inhaler technique and assessed their use of metered-dose inhalers (MDIs), various dry powder inhalers (DPIs), and Respimat using predefined checklists. Then they watched tablet-based multimedia educational videos that demonstrated correct inhaler technique by a clinical pharmacist with teach-back from a patient and were re-evaluated. We also recruited patients with COPD and assessed their use of their prescribed inhalers and then retested them after 3-6 months. Baseline and follow-up respiratory symptoms were measured by the COPD Assessment Test.
Results: Fifty-eight providers and 50 subjects participated. For all providers, correct inhaler technique (reported as percentage correct steps) increased after the videos: MDI without a spacer (72% vs 97%) MDI with a spacer (72% vs 96%), formoterol DPI (50% vs 94%), mometasone DPI (43% vs 95%), tiotropium DPI (73% vs 99%), and Respimat (32% vs 93%) (before vs after, P < .001 for all comparisons). Subjects also improved their inhaler use technique after viewing the educational videos: MDI without a spacer (69% vs 92%), MDI with a spacer (73% vs 95%), and tiotropium DPI (83% vs 96%) (before vs after, P < .001 for all comparisons). The beneficial effect of this educational intervention declined slightly for subjects but was durably improved after several months. COPD Assessment Test scores did not demonstrate any change in respiratory symptoms.
Conclusions: A tablet-based inhaler education tool improved inhaler technique for both providers and subjects. Although this intervention did show durable efficacy for improving inhaler use by patients, it did not reduce their respiratory symptoms.
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http://dx.doi.org/10.4187/respcare.05008 | DOI Listing |
Eur J Clin Pharmacol
September 2025
Department of Clinical Pharmacy and Pharmacology, University of Groningen, and University Medical Center Groningen, Groningen, The Netherlands.
Purpose: Non-adherence to inhaled medication poses a significant clinical and economic burden on patients with respiratory diseases. This narrative review provides an overview of key aspects of hair analysis, in general and specific for inhaled medications, and explores the potential of hair analysis as a novel tool to monitor adherence to inhaled medications.
Methods: PubMed searches were conducted to explore four aspects: (1) mechanisms of (inhaled) drug's systemic absorption and deposition in hair; (2) quantification of drugs in hair; (3) factors impacting (inhaled) drug hair concentrations; and (4) clinical studies assessing inhaled medication adherence through hair analysis.
Anesthesiology
October 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Background: Anesthetic exposure in young children raises concerns about neurodevelopmental safety, with preclinical evidence suggesting potential neurotoxicity of volatile anesthetics. This study aimed to assess whether the combination of dexmedetomidine and remifentanil, by reducing sevoflurane exposure, has any differential effect on neurodevelopmental outcomes in young children compared with sevoflurane alone.
Methods: This study was a prospective, double-blind, randomized clinical trial including children younger than 2 yr undergoing nonstaged, nonrepetitive surgeries.
Pediatr Pulmonol
September 2025
Intensive Care Service, Hospital Germans Trias i Pujol, Badalona, Spain.
Purpose: There is limited evidence to guide the use of enteral nutrition (EN) for children with bronchiolitis who received Humidified high flow nasal cannula (HHFNC) and often kept nil per mouth for aspiration and progression to mechanical ventilation risk.
Methods: This quality improvement project included children with bronchiolitis who were supported by HHFNC in the paediatric intensive care unit (PICU). An algorithm to increase EN use in those participants was created by stakeholders.
Respirology
September 2025
Department of Pharmacy, College of Pharmaceutical Sciences, National Yang, Ming Chiao Tung University, Taipei, Taiwan.
Background And Objective: Women with asthma should continue controller therapy during pregnancy, but current evidence on the effects of inhaled corticosteroids (ICS) and long-acting beta2-agonists (LABA) on adverse fetal outcomes remains unclear.
Methods: This was a population-based retrospective cohort study. Data were derived from the Health and Welfare Database, Birth Certificate Application, and Maternal and Child Health Database in Taiwan, from January 1, 2007 to December 31, 2018.
Cancer Pathog Ther
September 2025
Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27708, United States.
Background: Stereotactic body radiotherapy (SBRT) is an effective treatment for early-stage non-small cell lung cancer. However, patient breathing can affect treatment accuracy. Therefore, this study aimed to develop a bi-polar (BP) gated motion management strategy for SBRT and evaluate its feasibility geometrically and dosimetrically.
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