BIRD Summer Studentship: Inhaler ease of use and inhalation flow rate in people with rheumatoid arthritis

Many people with rheumatoid arthritis (RA) use inhalers, because of respiratory co-morbidities. Anecdotally, it is thought they find it difficult to manipulate these devices, especially if RA affects their fingers[1]. However, this has not been formally investigated and it is not known whether the lung complications which affect 30-50% of people with RA impair their ability to inhale at the necessary rate to use an inhaler[2]. The aim of this project is to compare the usability of three typical inhaler devices in groups of people with and without RA, and to assess whether they can achieve the necessary inspiratory flow rate. People with RA will be recruited via patient groups and an age-matched group without RA via pharmacies. Usability will be assessed using placebo inhalers; participants will be scored based on the number of inhaler use steps achieved. Inspiratory flow will be measured using the In-Check DIAL device. Primary outcomes will be the percentage of each group able to successfully use each type of inhaler and achieve the necessary inspiratory flow. Results will be related to RA history, activity and site to produce recommendations for the selection of inhalers for people with RA and the design of more easily used devices.

Many people with rheumatoid arthritis (RA) use inhalers, because they also have lung diseases. These people may find it difficult to use inhalers, especially if RA affects their fingers. However, this has not been properly researched. Also, some people’s RA also affects their lungs and we do not know whether this can stop them breathing in quickly enough to use an inhaler properly. The aim of this project is to compare the usability of three different inhalers by groups of people with and without RA. The speed at which these groups can breathe in will also be compared. Members of RA patient groups will be invited to take part. Pharmacy customers without RA will be asked to join the second group. The researcher will watch members of each group while they try to use dummy inhalers to see how many can do this. The speed at which they can breathe in through an inhaler will be measured using a device called the In-Check DIAL. The results of the two groups will be compared to see if people with RA find it more difficult to use certain inhalers. This will help health professionals chose the most usable inhalers with people with RA.