People Living with Chronic Obstructive Pulmonary Disease (COPD) and Inhalers: Insights and Suggestions from a Human Factors Study on NEXThaler

Nicola Scichilone,1 Andrew Whittamore,2 Chris White,3 Elena Nudo,4 Massimo Savella,4 Marta Lombardini4 1Division of Respiratory Medicine, Department PROMISE, “Giaccone” University Hospital, University of Palermo, Palermo, Italy; 2Portsdown Group Practice, Asthma, and Lung UK, Portsmouth, UK; 3Human Factors Department, Rebus Medical LTD, Bristol, UK; 4Medical Affairs, Chiesi Farmaceutici S.p.A., Parma, ItalyCorrespondence: Nicola Scichilone, Dipartimento di Biomedicina e Medicina Specialistica, Sezione di Pneumologia, University of Palermo, Via Trabucco 180, Palermo, 90146, Italy, Tel +39-091-6552146, Email [email protected]: COPD treatment relies mostly on drug administration via inhaler. Adherence to therapy is highly dependent on inhaler features and patient training. With the aim of identifying patients’ unmet needs and expectations about inhalers, data from a recent human factors study involving COPD patients have been analyzed. The specific use of the NEXThaler, a multidose dry powder inhaler that is activated by the patient’s inhalation, and its potential impact on adherence was explored.Methods: Adult patients with moderate to severe COPD were interviewed across 8 European countries using 90-minute semi-structured interviews to assess symptoms, services, challenges, patient expectations, and feedback on current inhalers. Patients participated in a simulation of NEXThaler use and watched a training video; they were asked to rate the device’s key features regarding treatment experience, confidence, and quality of life and provide suggestions for improvement.Results: The 62 patients interviewed most appreciated an inhaler’s ease of use, followed by the presence of an inhalation counter and a comfortable mouthpiece. Some patients were more interested in the drug itself rather than in the delivery device. Overall, the participants had positive feedback about NEXThaler, appreciating its ease of use, the low inhalation effort required to activate it, and the presence of both the inhalation click (referred to as the “click of confidence” because it gives COPD patients confidence that the dose has been released correctly) and the inhalation counter.Conclusion: NEXThaler has been appreciated for its three differentiating features (click of confidence, low inhalation effort, and inhalation counter), which have been shown to have a positive impact on patient’s lives, treatment experience, and confidence. This can potentially translate into improved medication adherence with a positive impact on the QoL of people living with COPD.Keywords: dry powder inhaler, breath-actuated, treatment adherence, COPD, adherence, patient, advocacy, patient