Abstract
Metered Door Inhaler and Dry powder inhaler are both used to treat the symptoms, such as: wheezing, coughs etc. of pulmonary disease in a Patient. The main objective of this study is to find out the comparative analysis of pMDI & DPI in asthma medication at rural area of Bangladesh. A cross sectional study including survey and interview was completed at in the outpatients department (OPD) of Patuakhali 250 Bed Sadar Hospital, Patuakhali. The sample was 120 Asthma patients studied over a period of six months from January 2019 to July 2019. The measurements of FEV1 & VC demonstrate airflow obstruction and following the administration of a bronchodilator, confirm the diagnosis when a 15% (and 200ml) improvement in FEV1 is noted. Subsequent follow-up were done by Peak Flow Meter. Medications were used as single maintenance & reliever therapy using Budesonide (ICS) & Formeterol (LABA). Devices that were used for the study are Pressurized Metered Dose Inhaler (pMDI) and Dry Powder inhaler (DPI) eg: Aerolizer. Proper inhalation techniques of the inhaler were demonstrated to the patients by the health care staffs from the hospital.
pMDI and DPI (Aerolozer) have no significant differences in compliance issue in patient’s points of view in terms of rural Bangladesh perspective. DPIs are flow dependent and require minimal patient to device co-ordination. pMDI requires patient to device co-ordination.
Keywords: MDI, SMART, DPI, In-Check DIAL,
References
- Davisdson,s principles and Practice of medicine- 23rd edn: Respiratory medicine chapter –Chronic obstructive pulmonary disease: Asthma section.
- Hassan MR, Hossain MA, Mahmud MA, Kabir ARM, Amin RM, et al. editors. National Guidelines Asthma Bronchiolitis COPD, Asthma Association, Bangladesh 3rd 2005. 19-133.
- Global Burden of Asthma. Global Initiative for Asthma (GINA), 2004.
- Managing Asthma in SMART Fashion: A Review: K H Jessy et all: Chest & Heart Journal 2012; 36(1):81-87.ISSN 1562-5044.
- National guideline:Asthma & COPD;Asthma Association:Bangladesh;5th edn: Jan:2016 asthmabd.net.
- Pittsburgh Regional Health Initiative and Center for Healthcare Quality and Payment Reform © 2008-2011
- Kawamatawong T, Khiawwan S, Pornsuriyasak P. J Asthma Allergy. 2017 Feb 23;10:17-21. doi: 10.2147/JAA.S127580. eCollection 2017, Peak inspiratory flow rate measurement by using In-Check DIAL for the different inhaler devices in elderly with obstructive airway diseases.
- Asthma care and factors affecting medication compliance: the patients point of view. International Journal for Quality in Health
- Care 2001; Volume 13, Number 5: pp. 375–383
- Buhl R. Volglelmeier C. Budesonie/Formeterol Mainatnence and Reliever Therapy. A new treatment approach for adult patients with asthma September 16,2007; http//:www.redorbit.com
- Edward J. Sondik, Ph.D., Director , Jennifer H. Madans, Ph.D., Associate Director for Science , National Center for Health Statistics , National Surveillance of Asthma: United States, 2001–2010 , Series 3, Number 35. Available at https://www.cdc.gov/nchs/data/series/sr_03/sr03_035.pdf
- https://www.sciencedirect.com/topics/nursing-and-health professions/metered-dose-inhaler
- Santus P, Giovanneli F, Marco FD et al. Budesonide/formeterol dry powder in asthma:an option for control as maintanence & reliever therapy. Expert opin,Pharmacother 2010;11(2):257-267.
- Jeanne E. Moorman, MS,1 Rose Anne Rudd, MSPH,1 Carol A. Johnson, MPH,1 Michael King, PhD,1 Patrick Minor, MSPH,1, 2 Cathy Bailey, MS,1 Marissa R. Scalia, MPH,1, 3 Lara J. Akinbami, MD4 1Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC 2Lockheed Martin, Atlanta, Georgia 3Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee 4Office of Analysis and Epidemiology, National Center for Health Statistics, CDC. National Surveillance for Asthma --- United States, 1980--2004 Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5608a1.htm
- Martinez FD , Helms PJ Types of asthma and wheezing. The European Respiratory Journal. Supplement [01 Jul 1998, 27:3s-8s]. Available at http://europepmc.org/abstract/med/9699776
- Mary Spitak Bilitski MSN, RN, Sally Wenzel MD; Cathy Vitari BSN, RN AE-C. American Thoracic Society: Patient Information Series. Available at https://www.thoracic.org/patients/patient-resources/resources/asthma.pdf
- Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP Asthma Treatment & Management,
- Updated: Nov 20, 2017. Available at https://emedicine.medscape.com/article/296301-treatment
- Praveen Buddiga, MD Physician, Allergy, Asthma and Immunology, Baz Allergy, Asthma and Sinus Center, Use of Metered Dose Inhalers, Spacers, and Nebulizers. Available at https://emedicine.medscape.com/article/1413366-overview#a2
- Thomas M Pavord I, Single inhaler maintanence and reliever therapy (SMART) in general practice asthma management.
Corresponding Author
Dr D S M Zakir Hossain
Assistant Professor, Respiratory Medicine, Patuakhali Medical College, Patuakhali