Opinion and Knowledge of Pulmonologists, Primary Care Physicians, and Nurses About Inhaled Therapy in COPD. Inhal-Epoc Survey

Javier De Miguel-Díez,1 Jordi Giner Donaire,2 José Tomas Gómez Sáenz,3 Juan Antonio Trigueros Carrero,4 Remei Artigas Feliu,5 Núria Cruz Culebra,5 Vicente Plaza6 1Pulmonology Service, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain; 2Pulmonology and Allergology Service, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain; 3Nájera Health Center, La Rioja, Spain; 4Buenavista Health Center, Toledo, Spain; 5Grupo Menarini España, Medical Department, Barcelona, Spain; 6Pulmonology and Allergology Service, Hospital de la Santa Creu I Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, SpainCorrespondence: Javier De Miguel-Díez, Pulmonology Service, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/Dr. Esquerdo, 46, Madrid, 28007, Spain, Email [email protected]: Despite the efforts made to improve inhalation technique by both patients and healthcare professionals, significant deficiencies were found in critical aspects of inhaler use and device selection. The aim of this study is to know the current opinion and knowledge of pulmonologists, primary care physicians, and nurses about inhaled therapy in chronic obstructive pulmonary disease (COPD).Methods: Survey conducted between April-July 2023 by a committee of experts formed by 2 pulmonologists, 2 primary care physicians, and one nurse specialist in inhaled therapy. It consisted of 27 questions and was sent by e-mail to professionals throughout Spain with experience in the management of COPD with inhaled therapy.Results: A total of 554 experts from all over Spain participated. Thirty-one percent and 43.5% of the respondents could not identify, respectively, which were the critical steps for correct inhalation of the pressurized metered-dose inhaler (pMDI) and the multidose dry powder inhaler (DPI). Conventional pMDIs were considered to be the devices that provide greater oropharyngeal deposition and less pulmonary deposition. The majority of respondents considered essential or important to take into account the patients’ opinion in selecting the inhaler, and preferred to review the inhalation technique rather than change the device. The main criteria for the choice of inhaler in COPD patients were their previous experience, preference, and severity. With a wide dispersion of results, Ellypta®, pMDI with chamber, Genuair®, Respimat®, and conventional pMDI were preferred in that order.Conclusion: Knowledge about inhaled therapy in COPD remains insufficient. There is a significant and important lack of knowledge in key aspects of the use of inhaler devices, such as the critical steps for correct inhalation and the selection criteria for inhalation devices. It is necessary to continue promoting training programs for both patients and healthcare personnel in inhalers and inhalation techniques.Keywords: COPD, DPI, inhalation device, inhaled therapy, pMDI