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(Chest. 2000;117:542-550.)
© 2000 American College of Chest Physicians

Inhaled Corticosteroids for Asthma Therapy*

Patient Compliance, Devices, and Inhalation Technique

Mac G. Cochrane, MD; Mohan V. Bala, PhD; Kristen E. Downs, MSPH; Josephine Mauskopf, PhD and Rami H. Ben-Joseph, PhD

* From Guy’s Hospital (Dr. Cochrane), London, UK; Centocor, Inc. (Dr. Bala), Malvern, PA; Research Triangle Institute (Ms. Downs and Dr. Mauskopf), Research Triangle Park, NC; and Merck & Co (Dr. Ben-Joseph), Whitehouse Station, NJ.

Correspondence to: Josephine A. Mauskopf, PhD, Research Triangle Institute, 3040 Cornwallis Rd, Box 12194, Research Triangle Park, NC 27709; e-mail: jom{at}rti.com

Background: Patient compliance, inhalation devices, and inhalation techniques influence the effectiveness of inhaled medications.

Methods: This article presents the results of a systematic literature review of studies measuring compliance with inhaled corticosteroids, measuring inhalation technique with different inhalation devices, and estimating the proportion of inhaled drug that is deposited in the lung.

Results:Overall, patients took the recommended doses of inhaled medication on 20 to 73% of days. Frequency of efficient inhalation technique ranged from 46 to 59% of patients. Education programs have been shown to improve compliance and inhalation techniques. The lung deposition achieved with different inhalers depends on particle size as well as inhaler technique.

Conclusion: This review demonstrates that multiple factors may come between a prescription of an inhaled corticosteroid and the arrival of that medicine at its target organ, the lung.

Key Words: asthma • compliance • inhaler technique • inhalers




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