Common Administration Obstacles With Maintenance Therapy

Incorrect COPD medication administration is common

Administration errors can be an obstacle to COPD treatment goals1-4

>2/3

According to GOLD, >2/3 of patients make at least one error using an inhalation device.5

 

>2/3

According to GOLD, >2/3 of patients make at least one error using an inhalation device.5

 

COPD=chronic obstructive pulmonary disease; GOLD=Global Initiative for Chronic Obstructive Lung Disease.

Obstacles to proper inhalation technique with COPD devices may include:

DEVICE-SPECIFIC CHALLENGES4,6-8

Device specific challenges - specific breathing technique
Specific breathing technique

Device specific challenges - dosing feedback availability
Dosing feedback availability

Device specific challenges - required setup and maintenance
Required setup and maintenance

Device specific challenges - administration time
Administration time

 

PHYSICAL IMPAIRMENTS8-10
 

Physical impairments - age-related pulmonary changes
Age-related pulmonary changes

Physical impairments - dexterity and coordination issues
Dexterity and coordination issues*

Physical impairments - disease progression
Disease progression

 

*Dexterity and coordination issues may require caregiver assistance.

GOLD encourages regularly rechecking a patient's device technique to ensure proper medication administration5

GOLD encourages regularly rechecking a patient's device technique to ensure proper medication administration5

GOLD does not endorse any specific treatments.


References:
1. Braido F, Lavorini F, Blasi F, Baiardini I, Canonica GW. Switching treatments in COPD: implications for costs and treatment adherence. Int J Chron Obstruct Pulmon Dis. 2015;10:2601-2608.
2. Crompton GK, Barnes PJ, Broeders M, et al. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med. 2006;100(9):1479-1494. 
3. Tashkin DP, Fabbri LM. Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents. Respir Res. 2010;11(1):149.
4. Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(3):371-384.
5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2018 report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2018:1-123. 
6. Koehorst-ter Huurne K, Movig K, van der Valk P, van der Palen J, Brusse-Keizer M. The influence of type of inhalation device on adherence of COPD patients to inhaled medication. Expert Opin Drug Deliv. 2016;13(4):469-475.
7. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593-604.
8. Taffet EG, Donohue JF, Altman PR. Considerations for managing chronic obstructive pulmonary disease in the elderly. Clin Interv Aging. 2014;9:23-30.
9. Jarvis S, Ind PW, Shiner RJ. Inhaled therapy in elderly COPD patients; time for re-evaluation? Age Ageing. 2007;36(2):213-218.
10. Sulaiman I, Cushen B, Greene G, et al. Objective assessment of adherence to inhalers by COPD patients [published online ahead of print July 13, 2016]. Am J Respir Crit Care Med. doi: 10.1164/rccm.201604-0733OC.

Important Safety Information & Indication

Important Safety Information
 

LONHALA MAGNAIR is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

LONHALA MAGNAIR should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, LONHALA MAGNAIR can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with LONHALA MAGNAIR, it should be treated immediately with an inhaled, short-acting bronchodilator; LONHALA MAGNAIR should be discontinued immediately and alternative therapy instituted.

Immediate hypersensitivity reactions have been reported with LONHALA MAGNAIR. If signs occur, discontinue LONHALA MAGNAIR immediately and institute alternative therapy.

LONHALA MAGNAIR should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥2% of patients taking LONHALA MAGNAIR, and occurring more frequently than in patients taking placebo, were dyspnea (4.9% vs 3.0%) and urinary tract infection (2.1% vs 1.4%).

LONHALA solution is for oral inhalation only and should not be injected or swallowed. LONHALA vials should only be administered with MAGNAIR.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information and Patient Information for LONHALA MAGNAIR at www.sunovionprofile.com/lonhala-magnair.

Indication
 

LONHALA® MAGNAIR® (glycopyrrolate) is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.