Inhaled medications are the cornerstone of therapy for both asthma and COPD. Therapeutic guidelines help in the selection of safe and effective drugs; the selection of the device must also be patient-centered.
There is abundant evidence that optimized patient outcomes, minimized exacerbations and maximized adherence are obtained only with careful patient-device alignment; this entails consideration of patient device preferences, physical constraints on device use, and regular inhaler technique education.
Patients strongly prefer to have trusted health care practitioners who understand and incorporate their preferences when managing their care. Medication and device choices/switches should only be conducted by prescribers, with patient knowledge, consent and training, to support adherence and optimize outcomes. Drug or device restrictions or switches implemented for cost reasons should never compromise disease control or patient well-being.
While budget and sustainability concerns are important to all parties, enforced or encouraged switches among non-equivalent respiratory devices are neither health-based nor patient-focused.