Inhaler use in hospitalized patients with chronic obstructive pulmonary disease or asthma

Assessment of wasted doses

Sami Sakaan, Dagny Ulrich, Jenny Luo, Christopher K. Finch, Timothy Self

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Hospitalized patients with chronic obstructive pulmonary disease (COPD) or asthma routinely have inhaled medications ordered for acute and maintenance therapy. Treatment may be administered via metered-dose inhaler (MDI) or dry-powder inhaler (DPI). These products must be appropriately labeled to be released home with the patient or discarded before discharge. Objective: To assess the amount and estimated cost of wasted doses of medications via MDI or DPI for hospitalized patients with COPD/asthma. Methods: A retrospective study was conducted at a university-affiliated hospital. Patients admitted between January 2011 and June 2012 with a primary diagnosis of COPD or COPD with asthma and who were ≥40 years of age were included. Information collected included use of albuterol, ipratropium, inhaled corticosteroids, long-acting beta agonist, or tiotropium and whether treatments were given by nebulizer, MDI, MDI plus valved holding chamber (VHC), or DPI. The number of doses dispensed, as well as doses not used, via MDI, MDI + VHC, or DPI were collected from electronic medical records. Costs associated with wasted medications were evaluated. Results: Of 555 patient admissions screened, 478 (mean age, 66 years; 58% women; 74% African American) met study criteria. Of the total MDI or DPI doses dispensed, 87% were wasted, and associated hospital cost was approximately $86,973. Conclusions: Substantial waste of inhaled medications was found in our study. Practical strategies are needed to reduce wasted inhalers. Further assessment of this problem is needed in other US hospitals.

Original languageEnglish (US)
Pages (from-to)386-390
Number of pages5
JournalHospital Pharmacy
Volume50
Issue number5
DOIs
StatePublished - Jan 1 2015

Fingerprint

Metered Dose Inhalers
Pulmonary diseases
Nebulizers and Vaporizers
Dry Powder Inhalers
Powders
Chronic Obstructive Pulmonary Disease
Asthma
Inhalation Spacers
Electronic medical equipment
Costs
Costs and Cost Analysis
Adrenal Cortex Hormones
Hospital Costs
Electronic Health Records
Patient Admission
African Americans
Therapeutics
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Pharmacy
  • Pharmacology
  • Pharmacology (medical)

Cite this

Inhaler use in hospitalized patients with chronic obstructive pulmonary disease or asthma : Assessment of wasted doses. / Sakaan, Sami; Ulrich, Dagny; Luo, Jenny; Finch, Christopher K.; Self, Timothy.

In: Hospital Pharmacy, Vol. 50, No. 5, 01.01.2015, p. 386-390.

Research output: Contribution to journalArticle

Sakaan, Sami ; Ulrich, Dagny ; Luo, Jenny ; Finch, Christopher K. ; Self, Timothy. / Inhaler use in hospitalized patients with chronic obstructive pulmonary disease or asthma : Assessment of wasted doses. In: Hospital Pharmacy. 2015 ; Vol. 50, No. 5. pp. 386-390.
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