Valeria Perugini, Chin Kook Rhee, Ji-Yong Moon, Tiew Pei Yee, Seung Won Ra, Pietro Pirina, Kwang Ha Yoo, Bernardino Alcázar Navarrete, Caroline Gouder, Almadana Pacheco, Annie Navarro-Rolon, Matevz Harlander, Therese Lapperre, Sean Chee Hong Loh, David Fole, Elsa Naval, Pedro Jose Romero Palacios, Marc Miravitlles, Omar Usmani
{"title":"慢性阻塞性肺疾病患者的峰值吸气流量评估：一项多中心、观察性、前瞻性、现实研究","authors":"Valeria Perugini, Chin Kook Rhee, Ji-Yong Moon, Tiew Pei Yee, Seung Won Ra, Pietro Pirina, Kwang Ha Yoo, Bernardino Alcázar Navarrete, Caroline Gouder, Almadana Pacheco, Annie Navarro-Rolon, Matevz Harlander, Therese Lapperre, Sean Chee Hong Loh, David Fole, Elsa Naval, Pedro Jose Romero Palacios, Marc Miravitlles, Omar Usmani","doi":"10.1136/bmjresp-2024-002408","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic obstructive pulmonary disease (COPD) use dry powder inhalers (DPIs) for disease management. DPI effectiveness relies on the patient's peak inspiratory flow (PIF), which may not always be optimal. We conducted an observational multicentre, prospective, real-life cohort study to determine the prevalence of suboptimal PIF in patients with COPD.</p><p><strong>Methods: </strong>415 participants (11%, n=47 women, mean age=70±8.7 years, mean forced expiratory volume in 1 s (predicted %)=48.1%) recruited from 17 international centres had baseline PIF recorded with an In-Check Dial device at three resistance levels: (1) low, (2) high and (3) the participant's maintenance device. We also recorded PIF from participants as they would do at home to verify their proper inhalation technique. Participants underwent spirometry and completed questionnaires (COPD Assessment Test (CAT), Test of Adherence to Inhalers (TAI)-12).</p><p><strong>Results: </strong>Of the 415 participants, 18% of DPI users (n=75) exhibited suboptimal values of PIF (as typical PIF <than what was required for tested inhalers in the study) when evaluated across DPI resistance groups ranging from low (R1) to high (R5) resistance, compared with 14% of participants (n=60) using devices without resistance (R0). Additionally, 14% of study participants were incapable of producing an optimal PIF or unwilling to do so (27%), impacting medication effectiveness. Participants with suboptimal PIF values had higher mean total CAT score (17.7±7) compared with those with optimal PIF values (12.1±7.6). When assessed globally, 37% (n=56) of participants with suboptimal PIF values did not adhere to treatment, highlighting the need for improved patient education and support.</p><p><strong>Conclusion: </strong>Suboptimal PIF is common in COPD, requiring regular assessment and tailored inhalers.</p><p><strong>Trial registration number: </strong>NCT04606394. Encepp EUPAS34689.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481310/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessment of peak inspiratory flow in patients with chronic obstructive pulmonary disease: a multicentre, observational, prospective, real-life study.\",\"authors\":\"Valeria Perugini, Chin Kook Rhee, Ji-Yong Moon, Tiew Pei Yee, Seung Won Ra, Pietro Pirina, Kwang Ha Yoo, Bernardino Alcázar Navarrete, Caroline Gouder, Almadana Pacheco, Annie Navarro-Rolon, Matevz Harlander, Therese Lapperre, Sean Chee Hong Loh, David Fole, Elsa Naval, Pedro Jose Romero Palacios, Marc Miravitlles, Omar Usmani\",\"doi\":\"10.1136/bmjresp-2024-002408\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Patients with chronic obstructive pulmonary disease (COPD) use dry powder inhalers (DPIs) for disease management. DPI effectiveness relies on the patient's peak inspiratory flow (PIF), which may not always be optimal. We conducted an observational multicentre, prospective, real-life cohort study to determine the prevalence of suboptimal PIF in patients with COPD.</p><p><strong>Methods: </strong>415 participants (11%, n=47 women, mean age=70±8.7 years, mean forced expiratory volume in 1 s (predicted %)=48.1%) recruited from 17 international centres had baseline PIF recorded with an In-Check Dial device at three resistance levels: (1) low, (2) high and (3) the participant's maintenance device. We also recorded PIF from participants as they would do at home to verify their proper inhalation technique. Participants underwent spirometry and completed questionnaires (COPD Assessment Test (CAT), Test of Adherence to Inhalers (TAI)-12).</p><p><strong>Results: </strong>Of the 415 participants, 18% of DPI users (n=75) exhibited suboptimal values of PIF (as typical PIF <than what was required for tested inhalers in the study) when evaluated across DPI resistance groups ranging from low (R1) to high (R5) resistance, compared with 14% of participants (n=60) using devices without resistance (R0). Additionally, 14% of study participants were incapable of producing an optimal PIF or unwilling to do so (27%), impacting medication effectiveness. Participants with suboptimal PIF values had higher mean total CAT score (17.7±7) compared with those with optimal PIF values (12.1±7.6). When assessed globally, 37% (n=56) of participants with suboptimal PIF values did not adhere to treatment, highlighting the need for improved patient education and support.</p><p><strong>Conclusion: </strong>Suboptimal PIF is common in COPD, requiring regular assessment and tailored inhalers.</p><p><strong>Trial registration number: </strong>NCT04606394. 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Assessment of peak inspiratory flow in patients with chronic obstructive pulmonary disease: a multicentre, observational, prospective, real-life study.
Introduction: Patients with chronic obstructive pulmonary disease (COPD) use dry powder inhalers (DPIs) for disease management. DPI effectiveness relies on the patient's peak inspiratory flow (PIF), which may not always be optimal. We conducted an observational multicentre, prospective, real-life cohort study to determine the prevalence of suboptimal PIF in patients with COPD.
Methods: 415 participants (11%, n=47 women, mean age=70±8.7 years, mean forced expiratory volume in 1 s (predicted %)=48.1%) recruited from 17 international centres had baseline PIF recorded with an In-Check Dial device at three resistance levels: (1) low, (2) high and (3) the participant's maintenance device. We also recorded PIF from participants as they would do at home to verify their proper inhalation technique. Participants underwent spirometry and completed questionnaires (COPD Assessment Test (CAT), Test of Adherence to Inhalers (TAI)-12).
Results: Of the 415 participants, 18% of DPI users (n=75) exhibited suboptimal values of PIF (as typical PIF
Conclusion: Suboptimal PIF is common in COPD, requiring regular assessment and tailored inhalers.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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