However, COPD tends to be undertreated. Successful treatment of COPD with maintenance therapy depends on a complex constellation of factors.
First of all, in case of maintenance therapy with a DPI, it is crucial that the patient can generate sufficient Peak Inspiratory Flow Rate (PIFR). An optimal PIFR is one that is sufficient to disaggregate the powder from the inhaler into particles with a diameter smaller than 5 um that can adequately be inhaled into the lower respiratory tract. If the PIFR of the patient is lower than the optimal PIFR for the use of their DPI, the medication will not be inhaled optimally. This will negatively affect the effectiveness of the treatment.
Secondly, poor inhalation technique is also likely to reduce a patient’s PIFR. The most common inhalation technique errors made by patients with COPD include: an inadequate airflow, drug priming without inhalation, exhalation into the inhaler, and multiple inhalations.
Thus, improving a patient’s PIFR, selecting the right inhaler device, and teaching patients the correct inhalation technique are likely to ameliorate the success of the treatment. In combination with medication adherence, these factors are likely to improve the effectiveness of maintenance therapy in COPD patients. In turn this is likely to positively affect patients’ health status and is also likely to decrease the risk of exacerbations.