We compared five types of inhalers. The primary outcome was differences in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction after training, most common step of misuse, and factors affecting the accuracy of inhaler use. Further, we surveyed patient satisfaction with each device and found the most frequently error-prone steps. In this study, six inhaler device types were used by participants: Evohaler (GlaxoSmithKline, London, UK/Chiesi, Parma, Italy), Respimat (Boehringer Ingelheim, Ingelheim am Rhein, Germany), Turbuhaler (AstraZeneca, Lund, Sweden), Ellipta (GlaxoSmithKline), Breezhaler (Novartis, Basel, Switzerland), and Handihaler (Boehringer Ingelheim). However, Breezhaler and Handihaler were analyzed in the same group because of the similarities. Finally, five device types were compared.
Evohaler
Manufactured by GlaxoSmithKline
Sourced in United Kingdom
Evohaler is a pressurized metered-dose inhaler (pMDI) designed for the delivery of respiratory medications. It is a compact, portable device that uses a liquefied propellant to deliver a measured dose of medication directly to the lungs. The Evohaler device is intended for use with appropriate respiratory medications prescribed by a healthcare professional.
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2 protocols using evohaler
1
Comparing Inhaler Device Usability
2
Nebulized Fluticasone Deposition on Ciliated Cells
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Two different aerosol delivery methods were used to generate aerosol particles of fluticasone propionate: a) fluticasone propionate (2mg/2ml Flixotide, GSK, UK) nebulised via a jet nebuliser, AeroEclipse XL (Trudell Medical International, UK); b) fluticasone propionate (250g/actuation; Evohaler® GSK, UK) administered from a pressurised metered dose inhaler (pMDI) via an antistatic spacer device (InspiraChamber®; InspiRx, US). The valve of the holding chamber was removed to allow drug to settle directly on to cultures.
A system was developed that allowed nebulisation directly onto the surface of respiratory ciliated cell cultures at ALI (Supplementary Figure 1.A). This allowed the impaction of fluticasone particles on the surface of cells and their interaction with cilia to be observed in real-time and recorded using high-speed video microscopy (Motion Pro 4x camera (IDT, US);
A system was developed that allowed nebulisation directly onto the surface of respiratory ciliated cell cultures at ALI (Supplementary Figure 1.A). This allowed the impaction of fluticasone particles on the surface of cells and their interaction with cilia to be observed in real-time and recorded using high-speed video microscopy (Motion Pro 4x camera (IDT, US);
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