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oai:repisalud.isciii.es:20.500.12105/235292024-11-29T00:58:52Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Leving, Marika T author van Boven, Job FM author Bosnic-Anticevich, Sinthia Z author van Cooten, Joyce author Correia de Sousa, Jaime author Cvetkovski, Biljana author Dekhuijzen, Richard author Dijk, Lars author Garcia Pardo, Marina author Gardev, Asparuh author Gawlik, Radosław author van der Ham, Iris author Hartgers-Gubbels, Elisabeth Sophia author Janse, Ymke author Lavorini, Federico author Maricoto, Tiago author Meijer, Jiska author Metz, Boyd author Price, David B author Roman-Rodriguez, Miguel author Schuttel, Kirsten author Stoker, Nilouq author Tsiligianni, Ioanna author Usmani, Omar author Kocks, Janwillem H author 2022 Purpose: To assess the relationship between suboptimal Peak Inspiratory Flow (sPIF), inhalation technique errors, and non-adherence, with Healthcare Resource Utilisation (HCRU) in Chronic Obstructive Pulmonary Disease (COPD) patients receiving maintenance therapy via a Dry Powder Inhaler (DPI). Patients and methods: The cross-sectional, multi-country PIFotal study included 1434 COPD patients (≥40 years) using a DPI for maintenance therapy. PIF was measured with the In-Check DIAL G16, and sPIF was defined as a typical PIF lower than required for the device. Inhalation technique was assessed by standardised evaluation of video recordings and grouped into 10 steps. Patients completed the "Test of Adherence to Inhalers" questionnaire. HCRU was operationalised as COPD-related costs for primary healthcare, secondary healthcare, medication, and total COPD-related costs in a 1-year period. Results: Participants with sPIF had higher medication costs compared with those with optimal PIF (cost ratio [CR]: 1.07, 95% CI [1.01, 1.14]). Multiple inhalation technique errors were associated with increased HCRU. Specifically, "insufficient inspiratory effort" with higher secondary healthcare costs (CR: 2.20, 95% CI [1.37, 3.54]) and higher total COPD-related costs (CR: 1.16, 95% CI 1.03-1.31). "no breath-hold following the inhalation manoeuvre (<6 s)" with higher medication costs (CR: 1.08, 95% CI [1.02, 1.15]) and total COPD-related costs (CR 1.17, 95% CI [1.07, 1.28]), and "not breathing out calmly after inhalation" with higher medication costs (CR: 1.19, 95% CI [1.04, 1.37]). Non-adherence was not significantly associated with HCRU. Conclusion: sPIF and inhalation technique errors were associated with higher COPD-related healthcare utilisation and costs in COPD patients on DPI maintenance therapy. Leving MT, van Boven JF, Bosnic-Anticevich SZ, van Cooten J, Correia de Sousa J, Cvetkovski B, et al. Suboptimal Peak Inspiratory Flow and Critical Inhalation Errors are Associated with Higher COPD-Related Healthcare Costs. Int J Chron Obstruct Pulmon Dis. 2022 Sep;Volume 17:2401-15. 10.2147/COPD.S380736 1178-2005 International journal of chronic obstructive pulmonary disease http://hdl.handle.net/20.500.13003/18231 36185173 L2018087771 2-s2.0-85138903587 https://hdl.handle.net/20.500.12105/23529 864663600001 Suboptimal Peak Inspiratory Flow and Critical Inhalation Errors are Associated with Higher COPD-Related Healthcare Costs