Deborah Schor1, José Ângelo Rizzo2, Decio Medeiros3, Ana Carolina Dela Bianca4, Almerinda Rego Silva5, Carlos Nunes6, Mário Morais-Almeida7, Emanuel Sarinho8. 1. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: deborah.schor@gmail.com. 2. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Pneumology Department, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: jarizzo@hotlink.com.br. 3. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: daphgp@gmail.com. 4. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: caroldelabianca@hotmail.com. 5. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: almerindasilva@uol.com.br. 6. Algarve Immuno-Allergology Center, Portimão, Portugal. Electronic address: cnalvor@hotmail.com. 7. CUF Descobertas Hospital, Immuno-Allergy Department, Lisbon and CINTESIS (Center for Research in Health Technologies and Information Systems), Faculdade de Medicina Do Porto, Portugal. Electronic address: mmoraisalmeida@netcabo.pt. 8. Center for Research in Allergy and Clinical Immunology, Health Sciences Post-Graduation Program, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil. Electronic address: emanuel.sarinho@gmail.com.
Abstract
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices. METHODS:Sixty-three patients with poorly controlled asthma that had a BDp-pMDI prescription were randomized to use the inhaler coupled to a HmS made of 500 ml plastic bottles (Group HmS, n = 32) or to a VCS (Group VCS, n = 31) for 60 days. All were given training sessions. Asthma control was assessed through the Asthma Control Test (ACT) and forced expiratory volume in the first second (FEV1), both measured before, and 30 and 60 days after treatment began. RESULTS: Both groups showed significant improvement in ACT scores after 30 and 60 days compared to baseline values (an increase of 7 and 7.8 points for the HmS group and 5.9 and 7.0 points for the VCS group, respectively, p < 0.001). There was no statistically significant difference in ACT scores between groups at any observation time (P = 0.261). FEV1 showed the same behavior. CONCLUSIONS: A similar level of asthma control was achieved with beclomethasone-dipropionate administered through a pMDI whether the inhaler was coupled to the HmS or VCS. These results are significant for asthma control planning strategies in low-income communities. (Trial Register Number: RBR-5x4dc9).
RCT Entities:
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices. METHODS: Sixty-three patients with poorly controlled asthma that had a BDp-pMDI prescription were randomized to use the inhaler coupled to a HmS made of 500 ml plastic bottles (Group HmS, n = 32) or to a VCS (Group VCS, n = 31) for 60 days. All were given training sessions. Asthma control was assessed through the Asthma Control Test (ACT) and forced expiratory volume in the first second (FEV1), both measured before, and 30 and 60 days after treatment began. RESULTS: Both groups showed significant improvement in ACT scores after 30 and 60 days compared to baseline values (an increase of 7 and 7.8 points for the HmS group and 5.9 and 7.0 points for the VCS group, respectively, p < 0.001). There was no statistically significant difference in ACT scores between groups at any observation time (P = 0.261). FEV1 showed the same behavior. CONCLUSIONS: A similar level of asthma control was achieved with beclomethasone-dipropionate administered through a pMDI whether the inhaler was coupled to the HmS or VCS. These results are significant for asthma control planning strategies in low-income communities. (Trial Register Number: RBR-5x4dc9).
Authors: Ai Theng Cheong; Ping Yein Lee; Sazlina Shariff-Ghazali; Hani Salim; Norita Hussein; Rizawati Ramli; Hilary Pinnock; Su May Liew; Nik Sherina Hanafi; Ahmad Ihsan Abu Bakar; Azainorsuzila Mohd Ahad; Yong Kek Pang; Karuthan Chinna; Ee Ming Khoo Journal: NPJ Prim Care Respir Med Date: 2021-11-29 Impact factor: 2.871