Table 1.

Factors affecting patients’ attitudes to COPD therapy and their preferences for a specific inhaler device¹²–¹⁷

Disease and drug factors

Progressive nature of COPD (declining benefit)

Concerns about regular medication, including side effects

Potential side-effects of treatment

Perceived drug efficacy (symptom relief/prevention of exacerbations)

Device factors

Perceived device efficacy

Ease of use of device Need for actuation/inhalation coordination Ability to actuate device (strength, arthritis issues) Ability to generate sufficient inspiratory flows (dry powder inhalers)

Convenience of device Dose and refill frequency Dose counter Availability of combination inhalers

Feelings of stigmatization due to need for device use in public

Physician device preference

Availability of drug/device preparations

“Brand loyalty”

Cost

Time to learn; clear instructions

Size, weight, taste, device appearance

Cleaning issues

Disposability/environmental issues