Insights from Real-World Evidence on the Use of Inhalers in Clinical Practice

Introduction: Despite the ongoing innovations and the availability of numerous effective inhaled treatment options, achieving optimal disease control in most patients remains frequently disappointing. Unfortunately, although inhaled therapy is the cornerstone of respiratory disease management, the selection of the most appropriate inhaler is still overlooked or underestimated by some healthcare professionals, and inhaler misuse remains a significant challenge in managing chronic respiratory diseases, which impacts directly disease outcomes. Objectives/methods: In this real-world study, we investigate the most prescribed inhalers for both ambulatory and hospitalized patients, their associated critical inhaler use and treatment adherence, the frequency of inhaler switches after hospitalization, and the factors associated with these changes. Results: In our cohort of patients, we observed a high prevalence of critical inhaler errors, independently of good inhaler-handling knowledge. Most patients with a history of at-home inhaler use showed a maximum peak inspiratory flow (PIF)≥30 L/min, suggesting they were more likely to benefit from using dry powdered inhalers (DPIs). Despite the high rate of critical inhaler errors, only a small proportion of patients switched their inhaler type after hospitalization, being these changes predominantly associated to the type of therapy prescribed, regardless of patient misuse, compliance, or adherence to treatment. Conclusions: Our study highlights the urgent need for a more personalized inhaler selection and consistent monitoring by healthcare professionals to minimize inhaler misuse, increase treatment compliance and adherence, and improve disease management outcomes.