Comparative study between MDI vs DPI and its limitation Bangladesh Perspective

Objective: In this study our main goal is to compare the efficacy of MDI vs DPI and its limitation. Method: This randomized, open-label, parallel-designed trial was carried out at tertiary medical hospital from January 2021 to January 2022. Where a total of 200 adult patients with moderate-to-severe asthma, and compared the efficacy and safety for asthma control between the 2 groups (MDI, n=100, DPI, n=100) Results: During the study, majority were belonging to 26-33 years age group, 65%. Also, majority had asthma, 50%.in DPIs group 40% exhaling before taking the dose, followed by 86% cases were tilting the head while using the inhaler, all cases loading the dose, 21% cases holding breath after taking the dose, 98% cases were type of exhaling after inhaling the dose, 51% cases waiting around 1 minute between two consecutive inhalations, 47% cases were gargling after taking a corticosteroid inhalation. Whereas in MDIs groups 30% exhaling before taking the dose, followed by 81% cases were tilting the head while using the inhaler, no cases loading the dose, 50% cases holding breath after taking the dose, 92% cases were type of exhaling after inhaling the dose, 49% cases waiting around 1 minute between two consecutive inhalations, 53% cases were gargling after taking a corticosteroid inhalation.in MDIs group proportion of patients without asthma exacerbations was 62% and asthma exacerbations in hospitalization or an emergency department visit during the 12-week 3%. Whereas in DPIs group proportion of patients without asthma exacerbations was 80% and asthma exacerbations in hospitalization or an emergency department visit during the 12-week 4%. Moreover, in MDIs group 9% had Nasopharyngitis followed by 6% had bronchitis, 3% had headache where as in DPIs group 6.2% had Nasopharyngitis followed by 6.3% had bronchitis, 2% had rhinitis, 6% had headache. Conclusion: In conclusion, the study found that a large proportion of adult patients with COPD/asthma in the Lebanese population do not take MDIs/DPIs effectively. However, patients who used DPIs had considerably better administration method. It also revealed that a substantial number of patients were not obtaining the necessary device education. As a result, it is critical for healthcare practitioners to properly teach their patients in order to reap the most advantages from the devices and avoid exacerbations and worsening of symptoms.