Abstract
Aims:
To identify asthma patients who have experienced a non-consented switch (NCS) of their inhaler device and to explore the circumstances and impact of these switches.
Methods:
Nineteen asthma patients who had experienced an NCS of their inhaler device were recruited to participate in qualitative, semi-structured one-to-one interviews.
Results:
All 19 participants reported a switch in their asthma inhaler without consultation or approval. There was deterioration in asthma control reported by some participants, many remained unchanged, and two reported better outcomes. Regardless of any change in asthma control, all patients expressed discontent with the NCS. Many felt it had damaged their relationship with their doctor, their confidence in their asthma medication, and their perception of control over their disease.
Conclusions:
These qualitative interviews highlight the need to maintain clear and open communication with patients. Switching of patients' inhalers without their consent may diminish the self-control associated with good asthma management, leave the doctor-patient relationship damaged, increase resource utilisation, and waste medication.
Keywords: asthma, switching, inhaler devices, qualitative research, informed consent
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Footnotes
AW was an employee of GlaxoSmithKline during the time the study was being conducted. DP has consultant arrangements with: Aerocrine, Boehringer Ingelheim, Dey Pharmaceuticals, GlaxoSmithKline (GSK), Merck, Sharpe and Dohme (MSD), Novartis, Schering-Plough and Teva. He or his team have received grants and research support for research in respiratory disease from the following organisations: UK National Health Service, Aerocrine, AstraZeneca, Boehringer Ingelheim, GSK, MSD, Novartis, Pfizer, Schering Plough and Teva. He has spoken for: Boehringer.
SD, AL, HC, MM, MT have no conflicts of interest.