Background
Methods
Study design
Participants
Qualitative interviews
Data analysis
Results
Participant demographics
Asthma population | COPD population | |
---|---|---|
(n = 33) | (n = 42) | |
Age, years | 41 | 61 |
Duration of disease, years | 22.1 | 7.1 |
Self-reported disease severity, 1–10 scale* | 5.0 | 5.6 |
Current inhaler
†
| ||
DISKUS only, n | 21 | 11 |
HandiHaler and DISKUS, n | N/A | 10 |
HandiHaler only, n | N/A | 10 |
MDI/HFA, n | 10 | 11 |
DPI (other than DISKUS), n | 2 | N/A |
Findings from interviews: key attributes
Relevant emergent themes (no. of COPD/asthma patients reporting) | Relevant quotations to illustrate theme, COPD patients | Relevant quotations to illustrate theme, asthma patients |
---|---|---|
Ease of use
| ||
Ease and simplicity (16/17) | “Life made less complicated” | “It’s straight-forward in its use” |
“Very easy” | “You really don’t have to think about it, it’s that easy” | |
“Extremely easy to use” | “It a no brainer in how to use” | |
Simple/Intuitive (9/5) | “It’s simple and takes the frustration out of it” | “It has a very simple design” |
“It’s easy to learn to use” | “It is really well thought out” | |
“Really don’t need instructions to use the device, it’s very intuitive.” | ||
“You don’t need to be a rocket scientist to use the device, it’s really very simple” | ||
Simple steps (8/3) | “Just flip open the cover and inhale” | “Open and inhale” |
“One hand, one shot, no thought.” | “Pull back the lever and inhale” | |
Issues with Lever Action (2/5) | “Opening is a little difficult, the cover feels tight when I go to slide” | “Lever drags when I pinch it to slide it open” |
“Sometimes the lever would move back a little when I open it” | ||
Amount of time to use device
| ||
Quick/Just seconds (27/21) | “Takes no time at all to use” | “Less time than any other device” |
“I can’t imagine it being any faster to use” | ||
“3 to 4 seconds” | ||
“Only 3 seconds to use, it’s so easy” | “About the same amount of time as my current pump” | |
“No one will notice I’m using it, it’s so quick. I’m always on the go and this is a good thing” | ||
“It’s incredibly quick and fast” | ||
Number of steps (5/6) | “Open, inhale and close” | “Flip, inhale and rinse…you’re done” |
“Just a flip and you breathe it in” | “Just cock it, breathe and go” | |
Hand feel of the device
| ||
Fits hand (17/13) | “I have a small hand and it fits it well” | “Fits in my hand nicely” |
“It’s the right size and shape to fit my hand” | “It has a substantial feel that I like” | |
Never slipped (12/12) | “Never slipped from my hand” | “It never slipped so I never dropped it” |
“I don’t recall ever dropping it” | ||
“It doesn’t slip around when you grab it” | ||
“It never slipped from my hand always felt very secure” | ||
Not too large/compact (11/5) | “It’s compact and not bulky” | “It’s not that big, which is great” |
“It’s not too large, which I like” | “It has a compact size that’s good” | |
Comfortable to hold (7/3) | “The feel in my hand is comfortable” | “It’s comfortable in my hand” |
Easy to hold (6/2) | “It’s got a nice curve to it that makes it nice to hold” | “It has a texture that helps me to hold on to it” |
Like grip/design ridges (2/4) | “The ridge marks in the thing help me to hold it” | “It has little grippers that I like, ridges; they really help” |
Ease of opening/closing device
| ||
Easy (9/14) | “It’s easy to open with one hand” | “It’s obvious what to open and how and there is not much resistance to push it open and closed” |
“Just slides open and closed with little effort” | ||
“It really takes no strength to slide the cap” | ||
Simple (6/14) | “Just flip it and it’s open, it’s very easy to do” | “Trigger is the cover, it is so easy” |
“It’s just a simple operation, you can even do it with one hand” | “It’s really mistake proof” | |
“It’s simple to just pull open. It closes the same way.” | ||
Difficult to slide cover (4/3) | “Sometimes it may stick a little and I need to push a little harder” | “Takes a little pressure to open, was not real smooth” |
“A little harder to open than Advair” | “The lever action was a little gritty from time to time” | |
No problems (general) (3/3) | “Cover never got stuck, never had a problem” | “No complications, no troubles” |
“There just were no problems” | ||
Grips/ridges/lip (3/3) | “I can slide it over with my thumb. I use the little raised lip to push it over” | “I like the flare ups on the cover, makes it easier to open and close” |
Feel of device when placed to the lips
| ||
Fits well/seals well (14/17) | “It’s shaped like my lips so I felt I got a good seal” | “It fits well, there is more of it to fit to my lips” |
“Fit my lips perfectly” | “Easy to make a tight seal to be sure inhaling the medicine, and not air.” | |
“It seals better than others and I feel I get more of the medicine. I feel I’m getting the full dose.” | “Fit nicely to my lips” | |
Comfortable (12/9) | “It felt right” | “It was comfortable, I didn’t have to purse my lips” |
“It felt really good to hold it up to my lips” | “Just very comfortable” | |
“It felt very comfortable” | ||
Placement of lips (3/2) | “I feel it is a little too small or short, I need to get my mouth around it.” | “The mouthpiece is a little shallow, I put my mouth further up” |
Ease of activation
| ||
Works even with small breath (14/5) | “Worked even when my breath was shallow” | “I had no problem breathing in the medicine on days I could breathe, it was effortless” |
“It was not hard to draw out the medicine” | ||
“I didn’t feel I needed to suck as hard” | “I think it takes less breath to get the medicine in” | |
“One big inhale and I know I got the medicine” | ||
Easy (4/11) | “Less difficult than an MDI” | “Almost too easy, I called my doctor to make sure I was doing it right” |
“Very easy to inhale” | “It was just real easy to do” | |
Medicine delivery (7/7) | “I could feel the medicine. I could feel the powder going in” | “I could feel the air flowing through so I knew something was happening” |
“I just felt like I got all the medicine” | “Felt like I could feel the medicine and it was easy to direct it to the back of the mouth” | |
Not propelled (0/4) | “I would like it better if it was propelled” | |
“Don’t feel it the same way as a pump. I have no proof it’s working or dispensing.” | ||
Use and value of dose counter
| ||
Big/easy to see/read (17/19) | “I can see the red indicator even without my glasses” | “The black and white numbers are very easy to see” |
“I can read the numbers without my glasses” | “I can see them without my glasses” | |
“I don’t need to pull out my magnification to see the numbers” | “The numbers are big and easy to read” | |
“It’s large enough I can see it” | ||
Keeps me on track (12/6) | “Indicates to me when doses are getting low” | “Keeps me on track with my medicine” |
“Makes it easier for me to keep up and not forget” | “Helps me know if I took my medicine each day | |
“It’s easy to read. It tells me when to refill. And, I know if I took my medicine” | “I like to know if I missed a day, and this helps me | |
Red indicator (8/7) | “The red indicator tells me I’m close to being out of medicine” | “The red strip tells me when I’m low” |
“9 or less and it goes to red and tells me I’m getting close to being out of medicine” | “I like that it turns red when getting low, I know to reorder.” | |
“I like the red indicator” | ||
Helpful (6/6) | “It has actual numbers and that’s helpful, no guessing” | “It’s simply helpful” |
Ease of use
Dose counter
Cover
Inhalation
Handling and storage
Preference relative to other inhalers
Comparator device | No. of patients using comparator device | No. (%) of patients expressing preference for the ELLIPTA DPI |
---|---|---|
Total
| ||
DISKUS | 42 | 33 (79) |
MDI/HFA | 30 | 23 (77) |
HandiHaler | 20 | 19 (95) |
Asthma
| ||
DISKUS | 21 | 15 (71) |
MDI/HFA | 10 | 6 (60) |
COPD
| ||
DISKUS | 21 | 18 (86) |
MDI/HFA | 20 | 17 (85) |
HandiHaler | 20 | 19 (95) |
Relevant emergent themes (no. of patients reporting) | Clusters within theme (no. of raw mentions) | Relevant quotations to illustrate theme |
---|---|---|
A – DISKUS (N = 21)
| ||
Simpler and one less step (13) | Ease of use (5) | “Simply open, inhale, and close” |
“Easy and fool proof” | ||
Less steps or one step (4) | “One less movement, don’t need to slide that lever over” | |
“It’s one less step” | ||
Simplicity of use (4) | “Simple, we have enough complexity in our lives” | |
“Intuitive, easy to figure out how to use” | ||
Size and ease of handling (10) | Smaller, more compact (7) | “I like the size, it’s smaller” |
Fits hand / grip (5) | “Fits in my hand more comfortably” | |
“I like the grooves so it’s not slippery” | ||
Portability and storage (9) | Carries / packs well (8) | “Small, it fits in my shirt pocket” |
“Easy to carry in a pocket” | ||
Stores well (4) | “It’s easy to store because it stands up” | |
“It takes up less space” | ||
Mouthpiece (8) | Better seal, ensures delivery (6) | “With this mouthpiece I don’t worry about getting my medicine” |
“With lip seal I feel I’m getting the full benefit of the medicine” | ||
Comfortable size/shape (3) | “The shape makes the mouthpiece more comfortable” | |
“Mouthpiece is ergonomically designed” | ||
Counter (7) | Size (5) | “I like the size of the numbers” |
“Main reason is the big counter” | ||
Easy to see (3) | “I don’t have to squint to see the numbers” | |
Color (4) | Bland / dislike (3) | “The color doesn’t stand out” |
Diskus is better color (1) | “Purple is easier to find and helps me to remember to use” | |
B – MDI (N = 10)
| ||
Coordination (8) | No timing inhalation (4) | “I don’t have to worry about timing” |
“I have more control over getting the medication” | ||
Does not propel the medication (4) | “It doesn’t shoot out the medicine” | |
“I like the propellant because it pushes the medicine where it needs to be” | ||
Mouthpiece (5) | Good fit / good seal (3) | “Fit my mouth well” |
“Fit well” | ||
Mouthpiece size (2) | “It’s not a bulky size” | |
Ease of Use (5) | Ease (4) | “Very easy to use” |
“Well thought out to make it easy” | ||
Intuitive (1) | “Very easy and obvious what to do” | |
Dose counter (4) | Plan and keep track of doses (2) | “Counter helps me to plan ahead” |
Easy to read counter (2) | “I like the counter is better, it’s bigger and easier to read” | |
One piece cover (3) | One piece construction (2) | “Cover is attached and I can’t lose it” |
Sanitary (1) | “Covers the mouthpiece to keep it clean” |
Relevant emergent themes (no. of patients reporting) | Clusters within theme (no. of raw mentions) | Relevant quotations to illustrate theme |
---|---|---|
A – DISKUS (N = 21)
| ||
Mouthpiece seal and security of getting all the medication (15) | Security of getting all my medication (8) | “I know I’m getting a good seal and all the medication” |
“I’m more confident the medication gets where it’s supposed to go” | ||
“With this mouthpiece I know I’m not going to suck air” | ||
Mouthpiece fit/seal to lips (6) | “Mouthpiece fits the shape of my mouth” | |
“I like the mouthpiece and how it fits my lips” | ||
Mouthpiece comfort (2) | “Mouthpiece was more comfortable” | |
More airflow (1) | “I found it easier to inhale, I got more air flow” | |
Ease & comfort to hold and operate (13) | Easy/better grip (8) | “Has grip lines and makes it easier to hold” |
“The bigger top is easier to grip” | ||
Fits well in hand (3) | “More slim, it fits nicely in my hand” | |
Can operate with one hand (3) | “Easier to flip open and can do it with one hand” | |
More comfortable to hold (2) | “Feels comfortable when it’s in my hand” | |
Simple, less steps to operate (13) | One less step—saves time (8) | “One motion, no extra steps to open” |
“One less step” | ||
Easier/simpler to use/user friendly (7) | “Easier, no extra step” | |
“85% easier to use” | ||
Counter makes it easy to read dose (10) | Easy to see/read/don’t need glasses (5) | “Can glance at it and see the dose count” |
“I don’t need to put on my glasses to see it” | ||
Larger counter (4) | “Like it because it has a larger dose counter” | |
Informs me when low (2) | “Gives me knowledge of when I’ll run out of medicine” | |
Ease of storage (4) | Ability to stand (4) | “It’s easy to store because it stands up” |
B – HandiHaler (N = 20)
| ||
Simple mode of action / Fewer steps (17) | Simpler / not complex (11) | “Takes a lot less time to use” |
“This is much simpler because I have arthritis in my hands” | ||
Fewer steps / less time (8) | “I reach in my bag, grab the new device, open it, breathe and put it back; it’s much less time” | |
“Just takes less time” | ||
Difficulties managing Handihaler (4) | “Spiriva is more difficult, many more steps to manage and more messy” | |
Fewer components (7) | No capsules (5) | “Capsules are a pain in the butt” |
“Because there is no pill there is no complication” | ||
No blister pack (3) | “I don’t need a scissors to open the package that has the pill inside, which is good because I have arthritis” | |
Reliable (6) | More assured getting medicine (4) | “I wonder if I’m getting all the medication out of the capsule, and here I don’t have to worry.” |
Less chance for error (4) | “Less chance for mistakes—this is fool-proof” | |
“Much less chance of a mistake” | ||
C – MDI/HFA (N = 20)
| ||
Ease of operation (8) | No shaking/no priming (3) | “I don’t have to shake it, I like that.” |
One puff, not two (3) | “It’s easier because I only have to take one puff, instead of two” | |
Fewer steps (2) | “It’s just fewer steps to take” | |
Coordination (7) | Ease of operation (3) | “It’s easy because I have arthritis and I could pull down the cover (on ELLIPTA), it can be difficult to push down on the other device” |
No coordination (2) | “It’s simpler to do because there’s no timing to worry about” | |
Dose counter (4) | Has a counter (2) | “I like that it has a counter, I don’t think mine does” |
Easy to read counter (2) | “The counter is bigger and I don’t see as well, so this is good for me” | |
One piece cover (4) | Better cover (4) | “This is a better mouthpiece cover, it is much more secure” |