Inappropriate use of inhalers

Inhalation step by step: What your patients SHOULD be doing

Step 1: Remove the cap from the inhaler.

Step 2: Shake the inhaler well for 5 seconds.

Step 3: Hold the inhaler firmly by placing your index finger on top of the canister, and thumb on the bottom of the mouthpiece.

Step 4: Sit straight or stand

up.

Step 5: Tilt your head back slightly.

Step 6: Exhale away from the inhaler.

Step 7: Put the inhaler in your mouth. Press the inhaler and start breathing in at the same time. Take a slow and deep breath.

Step 8: Hold your breath for 10 seconds. Exhale slowly through your mouth or nose.

http://use-inhalers.com/how-to-use-mdi

Easier to use a spacer

Asthma & COPD in the UK The British Thoracic Society Guidelines/Scottish Intercollegiate Guidelines Network/NICE guidelines provide

evidenced Based Platforms for the management of patients with these conditions. The local health economies within the UK will only approve funding for specific projects if they meet the quality, innovation, productivity and prevention requirements of QIPP.

In terms of how this translates to prescribing, within the UK, prescribing follows the guidelines within the

BTS steps 1-5. Over the last 10years, but particularly over the last 5 years there has been an erosion of patients at

step 2 of the BTS guidelines, with patients being established onto step 3 earlier i.e. combination therapy. Step 3

medication is significantly more expensive than step 2 and there are real concerns that patients who could be

managed effectively at step 2 of the BTS guidelines are being initiated onto step 3 therapy and creating a cost burden

to the tax payer.

In addition patients who are controlled at step 3 are not being titrated downward to step 2 as also underlined in the

guidelines.

In many cases the reason for the poor asthma control can be attributed to the fact that a large number of

patients are not taking their preventer therapy regularly or indeed cannot use their pMDI inhaler effectively.

The addition of a spacer device or alternatively a change of inhaler device to another step 2 therapy for these patients

would represent a significant cost saving for the NHS. In particular many localities recognise that pMDIs are

difficult to use and that the addition of a spacer device is an extremely cost-effective intervention to prevent patients

progressing to step 3. Indeed several localities have stipulated that any patient being prescribed a pMDI should

always be co-prescribed a spacer. “Eddie Mcknight, Managing Director, NSHI Ltd

“

Spacer Chambers on the market in the UK

The Compact Space Chamber Plus Overview

.

Fits multiple pMDI connections due to flexible rubber connection, round and shaped

22 mm connection for standard mask fit

15 mm ISO standardConnection to attach a tracheostomy directly

Oval shaped mouth piece for greater comfort

Clear visibility of the valve moving allowing positive reinforcement of medication administration

Clean life long glass like polycarbonate body giving a new look for 12 months

Dishwasher proof, guaranteed for 12 months

Very Low resistance allows the valve to open wide allowing aerosol to pass to the patient on inhalation

Asthma UK help line

Medical Developments UK (MDUK) has become a silver corporate partner of Asthma UK, the UK’s leading asthma charity. As part of the agreement, MDUK will donate 25p to the charity from the sale of each of its spacers in the UK, including both the Space Chamber plus® and the Space Chamber plus Compact ®.

Asthma UK’s Clinical Lead Deborah Waddell said: “We know that the Space Chamber plus® is popular with patients and clinicians, so we are very pleased to welcome MDUK to our corporate partnership scheme

The Asthma UK Helpline number is 0800 121 62 44

(open Monday to Friday 9-5pm)

MDUK is supporting Asthma UK to bring improved techniques to asthma patients.25p from the sale of each unit of the Space Chamber Plus, Combo Space Chamber Plus, Compact Space Chamber Plus and Combo Compact Space Chamber Plus will be donated to Asthma UK, a registered charity, no. 802364.

Medical Testimonials

“We were very impressed with the Space Chamber Plus – with a low resistance valve, it’s easy to see when the spacer is being used correctly and it’s very useful to be able to connect easily to a tracheotomy tube. We were also pleased to note that this spacer is dishwasher safe.”

Vicky TaylorPractice Nurse, Northants

Equivalence in vitro testingIn vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber

Plus Flow Vu™ Anti‐static, and Aerochamber Plus Flow Vu™

Study Objective:To compare drug output and aerodynamic particle size distribution of combination inhalers, for the treatment of both the bronchoconstriction and

inflammatory aspects of asthma and chronic obstructive pulmonary disease (COPD), when delivered from different valved holding chambers

(VHCs): Space Chamber Plus (SCP), Compact Space Chamber Plus (CSCP), Aerochamber Plus Flow Vu and Aerochamber Plus Flow Vu

Anti‐static.

Conclusion:Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non‐antistatic valved holding chambers,

Chamber Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Antistatic, and

non‐antistatic Aerochamber Plus Flow Vu. Both Space Chamber Plus and Compact Space Chamber Plus are made of the same materials. The

shorter length of the Compact Space Chamber Plus easily fits into school bags, handbags or briefcases to allow easier storage and handling. Both

VHCs have a transparent body so that the respiratory valves and their movement can be easily seen

and therefore enables the confirmation of correct product operation and usage

In vitro Performance of Space Chamber Plus™ and Compact Space Chamber Plus™ compared with Aerochamber

Plus Flow Vu™Anti‐static

Study Objective:To compare particle size distribution, and therefore in vitro performance, of three different classes of drug (albuterol sulfate, beclomethasone

Dipropionate and ipratropium bromide) when delivered from three different valved holding chambers (VHCs).

Conclusion:Results of the aerodynamic particle size distribution study indicate that Medical Development International’s non‐antistatic VHCs, Space Chamber

Plus and Compact Space Chamber Plus, have equivalent in vitro performance to Trudell’s Aerochamber Plus Flow Vu Anti‐static.

Features of the MDI Spacer Chamber ®

• Unique patented Cross-Valve technologyTM

• Universal end suitable for all Meter Dose Inhalers

• Compact design

• Very low resistance ensures more than 20% respirable

particle delivery compared to other established spacer products 1

• Transparent design to allow you to see medication delivery and cross valve functionality

• Can be used with any international standard respiratory facemask

• Enables unrestricted and continuous breathing

• Deigned with detachable mask to enhance children to move up to without mask inhalation but with the security of having a mask if needed in one device

• No whistle as it leads to confusion and misunderstanding in patients

Open Closed

For Use by the old and young, COPD and Asthma patients