Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD

Alexander G. Duarte, Leon Tung, Wei Zhang, En Shuo Hsu, Yong Fang Kuo, Gulshan Sharma

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Determine the prevalence of suboptimal peak inspiratory flow rate (PIFR) and associated patient characteristics and compare PIFR measurements obtained with spirometry and In-Check DIAL® device in ambulatory patients with COPD. Methods: Patients underwent PIFR measurement with In-Check DIAL® device and pulmonary function testing with calibrated equipment. Group characteristics and lung function were compared for patients with suboptimal (≤ 60 L/min) and optimal (> 60 L/min) PIFR. Receiver operating curve analysis determined the best maximal forced inspiratory flow (FIF max) value in identifying optimal PIFR by gender and height. Results: From July 1, 2016 to January 31, 2018, a total of 303 patients with chronic obstructive pulmonary disease (COPD) had PIFR and pulmonary function measurements. Group mean age was 65.5 ± 11.3 years with equal gender distribution. Suboptimal PIFR was observed in 61 (20.1%) patients. A significant correlation was observed between PIFR and FIF max, inspiratory capacity and residual volume (RV) to total lung capacity (TLC) ratio. In the suboptimal PIFR group, mean FIF max measured by spirometry was significantly less compared with the optimal PIFR group; 178.5 ± 56.9 L/min and 263.4 ± 89.9 L/min, respectively (p<0.0001). Receiver operator curve analysis of FIF max to identify an optimal PIFR yielded an area under the curve of 0.79. Males < 65 inches had a suboptimal PIFR in 16.7 % of the Male cohort, while feMales < 65 inches had a suboptimal PIFR in 27.4% of the women. Conclusions: Suboptimal PIFR was present in 1 in 5 stable patients with COPD and was more frequent in short statured feMales. Spirometry determined FIF max was associated with PIFR based on gender and height.

Original languageEnglish (US)
Pages (from-to)246-255
Number of pages10
JournalChronic Obstructive Pulmonary Diseases
Volume6
Issue number3
DOIs
StatePublished - Jan 1 2019

Fingerprint

Dry Powder Inhalers
Spirometry
Chronic Obstructive Pulmonary Disease
Equipment and Supplies
Lung
Inspiratory Capacity
Total Lung Capacity
Residual Volume
Area Under Curve
Age Groups

Keywords

  • Chronic obstructive pulmonary disease
  • COPD
  • Dry powder inhaler
  • Inhalation therapy
  • Peak inspiratory flow rate
  • Pulmonary function test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{6417845eeeef401686ef86c624f754e6,
title = "Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD",
abstract = "Objectives: Determine the prevalence of suboptimal peak inspiratory flow rate (PIFR) and associated patient characteristics and compare PIFR measurements obtained with spirometry and In-Check DIAL{\circledR} device in ambulatory patients with COPD. Methods: Patients underwent PIFR measurement with In-Check DIAL{\circledR} device and pulmonary function testing with calibrated equipment. Group characteristics and lung function were compared for patients with suboptimal (≤ 60 L/min) and optimal (> 60 L/min) PIFR. Receiver operating curve analysis determined the best maximal forced inspiratory flow (FIF max) value in identifying optimal PIFR by gender and height. Results: From July 1, 2016 to January 31, 2018, a total of 303 patients with chronic obstructive pulmonary disease (COPD) had PIFR and pulmonary function measurements. Group mean age was 65.5 ± 11.3 years with equal gender distribution. Suboptimal PIFR was observed in 61 (20.1{\%}) patients. A significant correlation was observed between PIFR and FIF max, inspiratory capacity and residual volume (RV) to total lung capacity (TLC) ratio. In the suboptimal PIFR group, mean FIF max measured by spirometry was significantly less compared with the optimal PIFR group; 178.5 ± 56.9 L/min and 263.4 ± 89.9 L/min, respectively (p<0.0001). Receiver operator curve analysis of FIF max to identify an optimal PIFR yielded an area under the curve of 0.79. Males < 65 inches had a suboptimal PIFR in 16.7 {\%} of the Male cohort, while feMales < 65 inches had a suboptimal PIFR in 27.4{\%} of the women. Conclusions: Suboptimal PIFR was present in 1 in 5 stable patients with COPD and was more frequent in short statured feMales. Spirometry determined FIF max was associated with PIFR based on gender and height.",
keywords = "Chronic obstructive pulmonary disease, COPD, Dry powder inhaler, Inhalation therapy, Peak inspiratory flow rate, Pulmonary function test",
author = "Duarte, {Alexander G.} and Leon Tung and Wei Zhang and Hsu, {En Shuo} and Kuo, {Yong Fang} and Gulshan Sharma",
year = "2019",
month = "1",
day = "1",
doi = "10.15326/jcopdf.6.3.2018.0163",
language = "English (US)",
volume = "6",
pages = "246--255",
journal = "Chronic Obstructive Pulmonary Diseases",
issn = "2372-952X",
publisher = "COPD Foundation",
number = "3",

}

TY - JOUR

T1 - Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD

AU - Duarte, Alexander G.

AU - Tung, Leon

AU - Zhang, Wei

AU - Hsu, En Shuo

AU - Kuo, Yong Fang

AU - Sharma, Gulshan

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Determine the prevalence of suboptimal peak inspiratory flow rate (PIFR) and associated patient characteristics and compare PIFR measurements obtained with spirometry and In-Check DIAL® device in ambulatory patients with COPD. Methods: Patients underwent PIFR measurement with In-Check DIAL® device and pulmonary function testing with calibrated equipment. Group characteristics and lung function were compared for patients with suboptimal (≤ 60 L/min) and optimal (> 60 L/min) PIFR. Receiver operating curve analysis determined the best maximal forced inspiratory flow (FIF max) value in identifying optimal PIFR by gender and height. Results: From July 1, 2016 to January 31, 2018, a total of 303 patients with chronic obstructive pulmonary disease (COPD) had PIFR and pulmonary function measurements. Group mean age was 65.5 ± 11.3 years with equal gender distribution. Suboptimal PIFR was observed in 61 (20.1%) patients. A significant correlation was observed between PIFR and FIF max, inspiratory capacity and residual volume (RV) to total lung capacity (TLC) ratio. In the suboptimal PIFR group, mean FIF max measured by spirometry was significantly less compared with the optimal PIFR group; 178.5 ± 56.9 L/min and 263.4 ± 89.9 L/min, respectively (p<0.0001). Receiver operator curve analysis of FIF max to identify an optimal PIFR yielded an area under the curve of 0.79. Males < 65 inches had a suboptimal PIFR in 16.7 % of the Male cohort, while feMales < 65 inches had a suboptimal PIFR in 27.4% of the women. Conclusions: Suboptimal PIFR was present in 1 in 5 stable patients with COPD and was more frequent in short statured feMales. Spirometry determined FIF max was associated with PIFR based on gender and height.

AB - Objectives: Determine the prevalence of suboptimal peak inspiratory flow rate (PIFR) and associated patient characteristics and compare PIFR measurements obtained with spirometry and In-Check DIAL® device in ambulatory patients with COPD. Methods: Patients underwent PIFR measurement with In-Check DIAL® device and pulmonary function testing with calibrated equipment. Group characteristics and lung function were compared for patients with suboptimal (≤ 60 L/min) and optimal (> 60 L/min) PIFR. Receiver operating curve analysis determined the best maximal forced inspiratory flow (FIF max) value in identifying optimal PIFR by gender and height. Results: From July 1, 2016 to January 31, 2018, a total of 303 patients with chronic obstructive pulmonary disease (COPD) had PIFR and pulmonary function measurements. Group mean age was 65.5 ± 11.3 years with equal gender distribution. Suboptimal PIFR was observed in 61 (20.1%) patients. A significant correlation was observed between PIFR and FIF max, inspiratory capacity and residual volume (RV) to total lung capacity (TLC) ratio. In the suboptimal PIFR group, mean FIF max measured by spirometry was significantly less compared with the optimal PIFR group; 178.5 ± 56.9 L/min and 263.4 ± 89.9 L/min, respectively (p<0.0001). Receiver operator curve analysis of FIF max to identify an optimal PIFR yielded an area under the curve of 0.79. Males < 65 inches had a suboptimal PIFR in 16.7 % of the Male cohort, while feMales < 65 inches had a suboptimal PIFR in 27.4% of the women. Conclusions: Suboptimal PIFR was present in 1 in 5 stable patients with COPD and was more frequent in short statured feMales. Spirometry determined FIF max was associated with PIFR based on gender and height.

KW - Chronic obstructive pulmonary disease

KW - COPD

KW - Dry powder inhaler

KW - Inhalation therapy

KW - Peak inspiratory flow rate

KW - Pulmonary function test

UR - http://www.scopus.com/inward/record.url?scp=85073914079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073914079&partnerID=8YFLogxK

U2 - 10.15326/jcopdf.6.3.2018.0163

DO - 10.15326/jcopdf.6.3.2018.0163

M3 - Article

AN - SCOPUS:85073914079

VL - 6

SP - 246

EP - 255

JO - Chronic Obstructive Pulmonary Diseases

JF - Chronic Obstructive Pulmonary Diseases

SN - 2372-952X

IS - 3

ER -