The importance of inhaler devices in the treatment of COPD

Chronic obstructive pulmonary disease (COPD) represents a socio-economic burden and requires regular and ongoing treatment. Inhalation therapy is recommended at all stages of the disease and allows the delivery of active molecules directly to the target site of action, whilst minimising adverse side-effects. Inhalers therefore play a crucial role in the effective management of patients with COPD and their choice is as important as that of the drug. The three most important factors that influence inhaled drug deposition within the airways are the patient’s inhalation flow, the aerosol velocity, and the inhaled drug particle size. These ultimately impact on the amount of drug reaching the target site and therefore the functional and clinical responses of the patient. Furthermore, patients’ training and education in the use of inhalers have been shown to be directly related to the efficacy of the therapy. However, in daily clinical practice, too little consideration is given to the features of the different inhalers and to the ability of patients to properly handle the device, and precise recommendations are greatly needed to help healthcare professionals to advise and prescribe the most ‘appropriate’ inhaled drug/device product. The present review aims to provide the latest evidence on the importance of the inhaler device in the management of patients with COPD.