Patient preference for and satisfaction with inhaler devices

Preference for and satisfaction with inhaler devices may be associated with improved clinical outcomes, but this has not been proven to date. A screened Medline search for papers on preference for inhaler devices produced 29 studies on a variety of devices, with Advair Diskus® and TurbuhalerTM featuring prominently. Of the 23 studies sponsored by the pharmaceutical industry, the sponsor's device was preferred in 19. Interpretation of results was made more difficult because only two studies used robust instruments for measuring preference and satisfaction. Patients with unstable disease or who were unable to use inhalers were usually excluded, and the extent of instruction and coaching given in the studies was greater than that seen in everyday practice. Studies found no significant differences in clinical outcomes between devices (where measured). Although inhaler preference is a valid patient-reported outcome deserving of scientific study, assessment and reporting of preference outcomes should follow the same regulatory standards as other patient-reported outcomes