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CompletedNCT02447575Updated Oct 9, 2020Results posted

Detecting Errors In Using Metered Dose Inhalers (MDI) Among Asthma And Chronic Obstructive Pulmonary Disease (COPD) Patients

An interventional study of Education on Use of MDI in Asthma and Chronic Obstructive Pulmonary Disease, sponsored by Baylor College of Medicine. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-10-09.

Sponsored by Baylor College of Medicine · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
23
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Metered Dose Inhaler (MDI) and Dry Powdered Inhaler (DPI) are the two most common devices used to deliver medicine in conditions such as asthma and chronic obstructive pulmonary disease. It is well-known that most patients do not use correct technique when using a metered dose inhaler. This leads to poor control of their disease. This study is being done so the investigators can record the patient using the metered dose inhaler before and after a short teaching session. This information will be fed into an invitro system (device) to allow the researchers to study the effect of error on drug delivery. The device being used is the Rice R3 electronic flowmeter.

Read the detailed description

Metered Dose Inhaler (MDI) and Dry Powdered Inhaler (DPI) are the two most common platforms to deliver medicine for patients suffering from Asthma and chronic obstructive pulmonary disease, and are used for dispensing both controller and rescue medications. Despite well-known methods to manage Asthma and COPD, nearly 70-90% of the patients do not display correct technique in using an inhaler. Poor management and control of the disease due to inadequate inhaler usage has resulted in rising rates of hospitalizations, making chronic respiratory diseases among the top five causes of death worldwide. Through this study we aim to record the technique of MDI usage among Asthma and COPD patient and understand the errors in their technique. The various parameters of inhaler usage where patients can make an error are 1. Tidal volume, 2. inspiration flow rate, 3. Inspiration flow volume, 4. Timing of actuation of inhaler and 5. Breath-holding. The parameters will be recorded by the Cognita R3 electronic flowmeter for each patient and the errors in each MDI usage will be noted. Using ex-vivo modelling, the patient's MDI technique recorded will be used to study the impact of errors in technique on efficiency of MDI drug delivery.

02

Conditions studied

03

In context

Asthma

3,921 studies on the registry are indexed under Asthma; 507 are open to participants now.

This study's enrollment of 23 is below the median of 83 across 2,752 interventional studies indexed under Asthma.

Browse Asthma studies →

Lead sponsor

Baylor College of Medicine is the lead sponsor of 734 studies on the registry; 110 are open to participants now.

Of its 83 completed or terminated interventional studies of FDA-regulated products, 44 (53%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with a physician diagnosis of asthma or COPD taking inhaled medications using MDI
  • Age >18 years
  • Able to read and sign consent document

Exclusion criteria

Exclusion Criteria:

  • Patients having acute exacerbation
  • Patients who are unable to take medication from an MDI
05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
23 participants (actual)

Study arms

  • Other
    MDI use Evaluation

    All subjects took 2 or more puffs of the placebo metered dose inhaler (MDI), attaching the Cognita electronic flowmeter to show measurements during the MDI use. The inhaler technique is also evaluated by study staff prior to an education demonstration.

    Other: Education on Use of MDI

Interventions

  • OtherEducation on Use of MDI

    After the subject demonstrated the use of MDI with the electronic flowmeter in place, the intervention was provided- a short verbal education to demonstrate the correct use of MDI.

06

What researchers measure

Primary outcomes

  1. Inhaler Use Correctness

    This is an observational study, the aim is to record a variety of MDI usage techniques performed by patients. The technique is scored out of 7 for the following 7 steps: 1. Shaking (0 = not shaken, 1 = shaken) 2. Coordination (0 = MDI actuated before inhalation start, 1 = MDI actuated after inhalation start) 3. Flow rate (0 = mean inspiratory flow rate \<30L/min or greater than 60L/min, 1 = mean inspiratory flow rate between 30-60L/min) 4. Duration of inhalation (0 = duration of inhalation \<3 sec, 1 = duration of inhalation \>=3sec) 5. Orientation of inhaler (0 = inhaler not upright = \> 30° from the vertical position, 1 = inhaler upright = within 30° from the vertical position) 6. Number of exhalation (0 = exhalation during inhaler use, 1 = no exhalations) 7. Single Actuation (0 = less than 0 or more than 1 inhaler actuation, 1 = exactly 1 inhaler actuation) The total score is a minimum of 0 correct steps if all the steps are incorrect to a maximum of 7 correct steps.

    Time frame: Single event- Outcome measured per inhaler puff, during the single clinic visit.

07

Results

Posted Oct 9, 2020

Participant flow

Participant flow — Overall Study
MilestoneMDI Use Evaluation
Started23
Completed23
Not completed0

Outcome measures

PrimaryInhaler Use Correctness

This is an observational study, the aim is to record a variety of MDI usage techniques performed by patients. The technique is scored out of 7 for the following 7 steps: 1. Shaking (0 = not shaken, 1 = shaken) 2. Coordination (0 = MDI actuated before inhalation start, 1 = MDI actuated after inhalation start) 3. Flow rate (0 = mean inspiratory flow rate \<30L/min or greater than 60L/min, 1 = mean inspiratory flow rate between 30-60L/min) 4. Duration of inhalation (0 = duration of inhalation \<3 sec, 1 = duration of inhalation \>=3sec) 5. Orientation of inhaler (0 = inhaler not upright = \> 30° from the vertical position, 1 = inhaler upright = within 30° from the vertical position) 6. Number of exhalation (0 = exhalation during inhaler use, 1 = no exhalations) 7. Single Actuation (0 = less than 0 or more than 1 inhaler actuation, 1 = exactly 1 inhaler actuation) The total score is a minimum of 0 correct steps if all the steps are incorrect to a maximum of 7 correct steps.

Time frame:
Single event- Outcome measured per inhaler puff, during the single clinic visit.
Reported as:
Mean · correct steps
Inhaler Use Correctness
correct stepsMDI Use Evaluation
Inhaler Use Correctness3.52 ± 1.25

Adverse events

Collected over 1 day.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Single Arm Study I0/23 (0%)0/23 (0%)0/23 (0%)

Baseline characteristics

23 physician-diagnosed Asthma/COPD patients were recruited for the study.

Age, Continuous
Age, Continuous(years)MDI Use Evaluation
Mean39.65 ± 13.93
Sex: Female, Male
Sex: Female, Male(Participants)MDI Use Evaluation
Female17
Male6
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)MDI Use Evaluation
Region of Enrollment
Region of Enrollment(participants)MDI Use Evaluation
United States23
08

Study locations

1 site
  • Baylor College of Medicine
    Houston, Texas 77030, United States
09

References and documents

Publications

  • Biswas R, Hanania NA, Sabharwal A. Factors Determining In Vitro Lung Deposition of Albuterol Aerosol Delivered by Ventolin Metered-Dose Inhaler. J Aerosol Med Pulm Drug Deliv. 2017 Aug;30(4):256-266. doi: 10.1089/jamp.2015.1278. Epub 2017 Feb 3. PubMed 28157430 ↗

Study documents

  • Protocol and statistical analysis plan · Sep 9, 2020
  • Informed consent form · Sep 9, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 9, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02447575
Lead sponsor
Baylor College of Medicine
Collaborators
William Marsh Rice University
Responsible party
Nicola Hanania (Associate Professor of Medicine, Baylor College of Medicine) — Principal investigator
First posted
May 19, 2015
Start date
Feb 2015
Primary completion
Jul 2019
Completion
Jul 2019
Results posted
Oct 9, 2020
Last update
Oct 9, 2020

Study contacts

Nicola A Hanania, MD
principal investigator · Baylor College of Medicine

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2020. You cannot join it, but the record below documents what was studied.

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