The Choice of Device
The Choice of Device
Appropriate device selection is an important consideration for your COPD patients.1

Appropriate device selection is an important consideration for your COPD patients.1
Choices of long-acting bronchodilator delivery devices are currently limited to the following types. Each of these devices has particular attributes that may impact individual patients differently.2

Tap a device to see its attributes

For a side-by-side comparison of the different delivery devices, please view on a computer or tablet.

Metered-dose inhaler
Dry-powder inhaler
Soft-mist inhaler
Jet nebulizer
Metered Dose Inhaler1-3
Dry-Powder Inhaler3-6
Soft-Mist Inhaler2
Jet Nebulizer3,7
Size Small and portable Small and portable Small and portable Can vary in size and portability
Technique Device actuation; coordination of breathing and actuation required (1 coordinated breath) Breath-actuated (1 coordinated breath) Device actuation; requires specific breathing technique (2 coordinated breaths) Tidal breathing (several breaths over time)
Setup No drug preparation; device shaking required Pill insertion required with certain devices Multiple steps Multiple steps
Administration Time Short (seconds) Short (seconds) Short (seconds) Up to 20 minutes
Maintenance Minimal cleaning Minimal cleaning Minimal cleaning Multiple steps for cleaning
PIFR* Considerations Inhalation of medicine may be impacted by inspiratory effort Inhalation of medicine may be impacted by inspiratory effort Allows inhalation of medicine independent of inspiratory effort Allows inhalation of medicine independent of inspiratory effort
*PIFR=peak inspiratory flow rate.

References: 1. Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(3):371-384. 2. Tashkin DP. A review of nebulized drug delivery in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:2585-2596. 3. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005;127(1):335-371. 4. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593-604. 5. Al-Showair RA, Tarsin WY, Assi KH, Pearson SB, Chrystyn H. Can all patients with COPD use the correct inhalation flow with all inhalers and does training help? Respir Med. 2007;101(11):2395-2401. 6. Virchow JC, Crompton GK, Dal Negro R, et al. Importance of inhaler devices in the management of airway disease. Respir Med. 2008;102(1):10-19. 7. Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR. The role of nebulized therapy in the management of COPD: evidence and recommendations. COPD. 2012;9(1):58-72.

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