Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs

Marika T. Leving; Job F. M. van Boven; Sinthia Z. Bosnic-Anticevich; Joyce van Cooten; Jamie Correia de Sousa; Biljana Cvetkovski; Richard Dekhuijzen; Lars Dijk; Marina García Pardo; Asparud Gardev; Radosław Gawlik; Iris van der Ham; Elisabeth Sophia Hartgers-Gubbels; Ymke Janse; Federico Lavorini; Tiago Maricoto; Jiska Meijer; Boyd Metz; David B. Price; Miguel Roman-Rodríguez; Kirsten Schuttel; Nilouq Stoker; Ioanna Tsiligianni; Omar S. Usmani; Janwillem H. Kocks

doi:10.2147/COPD.S380736

Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs

Marika T. Leving, Job F. M. van Boven, Sinthia Z. Bosnic-Anticevich, Joyce van Cooten, Jamie Correia de Sousa, Biljana Cvetkovski, Richard Dekhuijzen, Lars Dijk, Marina García Pardo, Asparud Gardev, Radosław Gawlik, Iris van der Ham, Elisabeth Sophia Hartgers-Gubbels, Ymke Janse, Federico Lavorini, Tiago Maricoto, Jiska Meijer, Boyd Metz, David B. Price, Miguel Roman-RodríguezKirsten Schuttel, Nilouq Stoker, Ioanna Tsiligianni, Omar S. Usmani, Janwillem H. Kocks

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

43 Downloads (Pure)

Abstract

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.

Original language	English
Pages (from-to)	2401-2415
Number of pages	15
Journal	International Journal of Chronic Obstructive Pulmonary Disease
Volume	17
DOIs	https://doi.org/10.2147/COPD.S380736
Publication status	Published - 25 Sept 2022
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

chronic obstructive pulmonary disease
Dry Powder Inhaler
health economics
cost analysis
healthcare resource utilisation

Access to Document

10.2147/COPD.S380736Licence: CC BY-NC

Publisher version (open access)Final published version, 1.78 MBLicence: CC BY-NC

Cite this

Leving, M. T., van Boven, J. F. M., Bosnic-Anticevich, S. Z., van Cooten, J., de Sousa, J. C., Cvetkovski, B., Dekhuijzen, R., Dijk, L., Pardo, M. G., Gardev, A., Gawlik, R., van der Ham, I., Hartgers-Gubbels, E. S., Janse, Y., Lavorini, F., Maricoto, T., Meijer, J., Metz, B., Price, D. B., ... Kocks, J. H. (2022). Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs. International Journal of Chronic Obstructive Pulmonary Disease, 17, 2401-2415. https://doi.org/10.2147/COPD.S380736

@article{7a2f9f894e2441a4b1122e6669dbf859,

title = "Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs",

abstract = "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.",

keywords = "chronic obstructive pulmonary disease, Dry Powder Inhaler, health economics, cost analysis, healthcare resource utilisation",

author = "Leving, {Marika T.} and {van Boven}, {Job F. M.} and Bosnic-Anticevich, {Sinthia Z.} and {van Cooten}, Joyce and {de Sousa}, {Jamie Correia} and Biljana Cvetkovski and Richard Dekhuijzen and Lars Dijk and Pardo, {Marina Garc{\'i}a} and Asparud Gardev and Rados{\l}aw Gawlik and {van der Ham}, Iris and Hartgers-Gubbels, {Elisabeth Sophia} and Ymke Janse and Federico Lavorini and Tiago Maricoto and Jiska Meijer and Boyd Metz and Price, {David B.} and Miguel Roman-Rodr{\'i}guez and Kirsten Schuttel and Nilouq Stoker and Ioanna Tsiligianni and Usmani, {Omar S.} and Kocks, {Janwillem H.}",

note = "Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2022",

month = sep,

day = "25",

doi = "10.2147/COPD.S380736",

language = "English",

volume = "17",

pages = "2401--2415",

journal = "International Journal of Chronic Obstructive Pulmonary Disease",

issn = "1178-2005",

publisher = "Dove Medical Press Limited",

}

Leving, MT, van Boven, JFM, Bosnic-Anticevich, SZ, van Cooten, J, de Sousa, JC, Cvetkovski, B, Dekhuijzen, R, Dijk, L, Pardo, MG, Gardev, A, Gawlik, R, van der Ham, I, Hartgers-Gubbels, ES, Janse, Y, Lavorini, F, Maricoto, T, Meijer, J, Metz, B, Price, DB, Roman-Rodríguez, M, Schuttel, K, Stoker, N, Tsiligianni, I, Usmani, OS & Kocks, JH 2022, 'Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs', International Journal of Chronic Obstructive Pulmonary Disease, vol. 17, pp. 2401-2415. https://doi.org/10.2147/COPD.S380736

Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs. / Leving, Marika T.; van Boven, Job F. M.; Bosnic-Anticevich, Sinthia Z. et al.
In: International Journal of Chronic Obstructive Pulmonary Disease, Vol. 17, 25.09.2022, p. 2401-2415.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs

AU - Leving, Marika T.

AU - van Boven, Job F. M.

AU - Bosnic-Anticevich, Sinthia Z.

AU - van Cooten, Joyce

AU - de Sousa, Jamie Correia

AU - Cvetkovski, Biljana

AU - Dekhuijzen, Richard

AU - Dijk, Lars

AU - Pardo, Marina García

AU - Gardev, Asparud

AU - Gawlik, Radosław

AU - van der Ham, Iris

AU - Hartgers-Gubbels, Elisabeth Sophia

AU - Janse, Ymke

AU - Lavorini, Federico

AU - Maricoto, Tiago

AU - Meijer, Jiska

AU - Metz, Boyd

AU - Price, David B.

AU - Roman-Rodríguez, Miguel

AU - Schuttel, Kirsten

AU - Stoker, Nilouq

AU - Tsiligianni, Ioanna

AU - Usmani, Omar S.

AU - Kocks, Janwillem H.

N1 - Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2022/9/25

Y1 - 2022/9/25

N2 - 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.

AB - 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.

KW - chronic obstructive pulmonary disease

KW - Dry Powder Inhaler

KW - health economics

KW - cost analysis

KW - healthcare resource utilisation

UR - http://www.scopus.com/inward/record.url?scp=85138903587&partnerID=8YFLogxK

U2 - 10.2147/COPD.S380736

DO - 10.2147/COPD.S380736

M3 - Article

C2 - 36185173

SN - 1178-2005

VL - 17

SP - 2401

EP - 2415

JO - International Journal of Chronic Obstructive Pulmonary Disease

JF - International Journal of Chronic Obstructive Pulmonary Disease

ER -

Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Optimizing Maintenance Therapy in COPD Patients: Real-world observational study of peal inspiratory flow rate, inhalation technique and medication adherence

Cite this

Suboptimal Peak Inspiratory Flow and critical inhalation errors are associated with higher COPD-related healthcare costs

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Projects

Optimizing Maintenance Therapy in COPD Patients: Real-world observational study of peal inspiratory flow rate, inhalation technique and medication adherence

Cite this