Dry Powder Inhalation (DPI): the cornerstone of efficient inhaled drug delivery
What do physicians think of DPIs?
There are many practical aspects to inhaled drug delivery systems that can have a significant impact on the likelihood of patient compliance, with variance across patient groups according to age, social class, or work status. At present, the four devices examined in our survey (pMDIs, capsule-based, reservoir-based, and blisterbased DPIs) are used with the vast majority of treatments prescribed. We found that physicians cross the groups and two countries (France and Turkey) concurred on the principal factors that make an ideal inhaler: ease of use/handling; control of dose taking; portability; and multi-dose system. An in-depth evaluation of each of the four devices revealed a number of pros and cons for each and some suggestions or improvement were identified. pMDIs are the preferred device for the treatment of acute attacks because of the minimal handling required, despite some difficulty in achieving effective drug delivery. Overall, owever, capsule-based systems appear to be the most broadly acceptable across different patient groups, being intuitively simple to use and having the unique advantage of making the taking of inhaled medication a very tangible and reassuring experience. Potential improvements by developing multi-dose capsule-based devices with automatic loading to help improve patient convenience and compliance may take us one step closer to the ideal device by better fulfilling both clinical and patient needs.