Effect of peak inspiratory flow rate guided inhaler device selection on the number of COPD exacerbation in the 90 days after discharge

<bold>Introduction and Objective:</bold> Dry powder inhalers(DPI) require a peak inspiratory flow rate(PIFR) for drug disaggregation and delivery. The aim of study was to investigate the effect of PIFR guided inhaler device selection on the number of readmissions and symptoms 90 days after discharge in patients with COPD exacerbation. <bold>Materials and Method:</bold> 128 patients who were hospitalized due to COPD exacerbation were randomly assigned to the study and control groups. Patients underwent PIFR measurements with the In-Check Dial G16 at the no resistance level, then by adjusting the resistance according to the inhaler device used by the patients. Patients in the control group discharged with the same inhaler device. Patients in the study group were discharged with an inhaler device has an appropriate PIFR value. All patients were trained for the inhaler devices. The CAT and mMRC scores of all patients on the 30th and 90th days and readmissions for COPD exacerbation during this period were recording. <bold>Results:</bold> The median PIFR value of the 1st and 2nd inhaler devices given at discharge were higher in the study group. The median value of the number of admissions due to COPD exacerbation between the two groups in 30 days was similar, but in 90 days, it was higher in the control group. The median value of CAT and mMRC score was lower in the study group at hospitalisation, day 30 and 90. <bold>Conclusion:</bold> PIFR guided inhaler device selection was shown to reduce the number of exacerbations in 90 days postdischarge in patients with COPD exacerbation. PIFR guided inhaler device selection may improve patient compliance and reduce the number of exacerbations after discharge.