The Impact of Inhaler Device Regimen in Patients with Asthma or COPD.

Many inhaler devices with varying handling requirements for optimal use are available for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Patients may be prescribed different device types for their reliever and maintenance medications, which may lead to confusion and suboptimal device use. We aimed to understand if simplifying inhaler regimens by (i) using a single device type in patients who use multiple devices, or (ii) prescribing a device that a patient was already experienced with, could improve clinical and economic outcomes in asthma and COPD management. A targeted literature search was performed and additional articles were identified through hand searching of citations within screened publications. One hundred and fourteen articles were included in the final review. The findings suggest that simplifying inhaler regimens by using the same type of inhaler for concomitant inhaled medications over time minimizes device misuse, leading to improved clinical outcomes and reduced healthcare utilization in patients with asthma or COPD. Physicians should consider a patient's suitability for a device and their training needs when prescribing an inhaled medication and before changing the medication type or dose, especially when suboptimal treatment outcomes are observed. Whilst further research is required to determine if consistent use of the same device type is associated with better treatment adherence and persistence in patients with asthma or COPD, this literature review identified clinical benefits and reduced healthcare utilization with simplified inhaler regimens.