Physical ability of people with rheumatoid arthritis and age-sex matched controls to use four commonly prescribed inhaler devices

Yasmin Kafaei Shirmanesh, Matthew Jones

Research output: Contribution to journalArticle

1 Citation (Scopus)
18 Downloads (Pure)

Abstract

Background Respiratory disease is a common co-morbidity with rheumatoid arthritis (RA). RA commonly affects the hands, but there is little research investigating whether these patients are physically able to operate inhalers. Aim To compare the physical ability of people with and without RA to use four commonly prescribed inhaler devices (pressurised metered dose inhaler (pMDI), Easi-Breathe ®, HandiHaler ® and Turbohaler ®). Methods Adults with RA and an equal number of age-sex matched controls were observed using placebo inhaler devices. Maximum inhalation flow rate was measured with an In-Check Dial device. Dichotomous data were compared (RA versus control) using Fisher's exact test. Results Thirty four participants were recruited for each group. For all inhalers, fewer participants with RA were able to complete all the steps necessary to operate the device: pMDI (50% vs. 91%), Easi-Breathe ® (77% vs. 97%), HandiHaler ® (15% vs. 94%) and Turbohaler ® (85% vs. 100%). This difference was significant (p <.05) for the pMDI, Easi-Breathe ® and HandiHaler ®. Significantly fewer people (p <.05) with RA were able to depress the pMDI canister, or to complete three steps in the operation of the Handihaler ® (open the dust cap, remove the capsule from its blister, pierce the capsule). Only one participant (RA group) was unable to achieve the minimum flow rates required to operate the Turbohaler ® and HandiHaler ® (p = 1.000). Conclusions People with RA have varying physical abilities to use inhalers effectively. A person-centred approach is required to assess which inhaler device is appropriate for each individual patient.

Original languageEnglish
Pages (from-to)12-14
Number of pages3
JournalRespiratory Medicine
Volume135
Early online date8 Jan 2018
DOIs
Publication statusPublished - 1 Feb 2018

Fingerprint

Nebulizers and Vaporizers
Rheumatoid Arthritis
Equipment and Supplies
Metered Dose Inhalers
Capsules
Blister
Dust
Inhalation
Hand
Placebos
Morbidity

Keywords

  • Arthritis, Rheumatoid
  • Dry powder inhalers
  • Human engineering
  • Metered dose inhalers
  • Nebulizers and vaporizers

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Physical ability of people with rheumatoid arthritis and age-sex matched controls to use four commonly prescribed inhaler devices. / Kafaei Shirmanesh, Yasmin; Jones, Matthew.

In: Respiratory Medicine, Vol. 135, 01.02.2018, p. 12-14.

Research output: Contribution to journalArticle

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abstract = "Background Respiratory disease is a common co-morbidity with rheumatoid arthritis (RA). RA commonly affects the hands, but there is little research investigating whether these patients are physically able to operate inhalers. Aim To compare the physical ability of people with and without RA to use four commonly prescribed inhaler devices (pressurised metered dose inhaler (pMDI), Easi-Breathe {\circledR}, HandiHaler {\circledR} and Turbohaler {\circledR}). Methods Adults with RA and an equal number of age-sex matched controls were observed using placebo inhaler devices. Maximum inhalation flow rate was measured with an In-Check Dial device. Dichotomous data were compared (RA versus control) using Fisher's exact test. Results Thirty four participants were recruited for each group. For all inhalers, fewer participants with RA were able to complete all the steps necessary to operate the device: pMDI (50{\%} vs. 91{\%}), Easi-Breathe {\circledR} (77{\%} vs. 97{\%}), HandiHaler {\circledR} (15{\%} vs. 94{\%}) and Turbohaler {\circledR} (85{\%} vs. 100{\%}). This difference was significant (p <.05) for the pMDI, Easi-Breathe {\circledR} and HandiHaler {\circledR}. Significantly fewer people (p <.05) with RA were able to depress the pMDI canister, or to complete three steps in the operation of the Handihaler {\circledR} (open the dust cap, remove the capsule from its blister, pierce the capsule). Only one participant (RA group) was unable to achieve the minimum flow rates required to operate the Turbohaler {\circledR} and HandiHaler {\circledR} (p = 1.000). Conclusions People with RA have varying physical abilities to use inhalers effectively. A person-centred approach is required to assess which inhaler device is appropriate for each individual patient.",
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AB - Background Respiratory disease is a common co-morbidity with rheumatoid arthritis (RA). RA commonly affects the hands, but there is little research investigating whether these patients are physically able to operate inhalers. Aim To compare the physical ability of people with and without RA to use four commonly prescribed inhaler devices (pressurised metered dose inhaler (pMDI), Easi-Breathe ®, HandiHaler ® and Turbohaler ®). Methods Adults with RA and an equal number of age-sex matched controls were observed using placebo inhaler devices. Maximum inhalation flow rate was measured with an In-Check Dial device. Dichotomous data were compared (RA versus control) using Fisher's exact test. Results Thirty four participants were recruited for each group. For all inhalers, fewer participants with RA were able to complete all the steps necessary to operate the device: pMDI (50% vs. 91%), Easi-Breathe ® (77% vs. 97%), HandiHaler ® (15% vs. 94%) and Turbohaler ® (85% vs. 100%). This difference was significant (p <.05) for the pMDI, Easi-Breathe ® and HandiHaler ®. Significantly fewer people (p <.05) with RA were able to depress the pMDI canister, or to complete three steps in the operation of the Handihaler ® (open the dust cap, remove the capsule from its blister, pierce the capsule). Only one participant (RA group) was unable to achieve the minimum flow rates required to operate the Turbohaler ® and HandiHaler ® (p = 1.000). Conclusions People with RA have varying physical abilities to use inhalers effectively. A person-centred approach is required to assess which inhaler device is appropriate for each individual patient.

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