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Inhaler use in chronic obstructive pulmonary disease patients: a meta-analysis†

Li-Juan Zhou
Li-Juan Zhou
, 
Xian-Xiu Wen
Xian-Xiu Wen
, 
Rong Jiang
Rong Jiang
, 
Huang-Yuan Zhou
Huang-Yuan Zhou
, 
Yan Li
Yan Li
, 
Xiao-Rang Mao
Xiao-Rang Mao
 y 
Mei Lan
Mei Lan
   | 31 dic 2022
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Article Category: Review
Publicado en línea: 31 dic 2022
Páginas: 343 - 352
Recibido: 03 abr 2022
Aceptado: 31 ago 2022
DOI: https://doi.org/10.2478/fon-2022-0044
Palabras clave
© 2022 Li-Juan Zhou et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Literature search and selection.
Literature search and selection.

Figure 2.

Results of risk bias evaluation of randomized controlled studies.
Results of risk bias evaluation of randomized controlled studies.

Figure 3.

Forest plots of error rates for at least 1 inhaler.
Forest plots of error rates for at least 1 inhaler.

Figure 4.

A cross-sectional forest map of the error rates of different inhalants.
A cross-sectional forest map of the error rates of different inhalants.

Figure 5.

Forest plot of error rates for use. Abbreviation: DPI, dry powder inhaler.
Forest plot of error rates for use. Abbreviation: DPI, dry powder inhaler.

Figure 6.

Forest plot of error rates for quantified inhaler use.
Forest plot of error rates for quantified inhaler use.

Figure 7.

Forest plot of errors in SMI use. Abbreviation: SMI, soft mist inhalers.
Forest plot of errors in SMI use. Abbreviation: SMI, soft mist inhalers.

Figure 8.

Funnel plot of at least 1 inhaler error made.
Funnel plot of at least 1 inhaler error made.

Results of the JBI cross-sectional survey bias risk assessment.

Inclusion in the study Rationale for the title Population selection Exclusion criteria Sample characteristics Instrument reliability and validity tests Veracity Ethical principles Statistical methods Study Study results Study value Total score
Ngo et al.21 ② ① ② ① ① ② ② ② ② ② 17
Bournival et al.22 ② ① ① ① NA ② ① ② ② ② 14
Al Ammari et al.23 ② ① ① ① NA ② ② ② ② ② 15
Castel-Branco et al.24 ② ① ① ① NA ② ② ② ② ② 15
Pothirat et al.8 ② ① ① ① NA ② ② ② ② ② 15
Ding et al.25 ② ① ① ① NA ② NA ② ② ② 13
Press et al.26 ② ① ① ① ① ② ② ② ② ② 16

Results of risk of bias evaluation of the included literature by NOS score.

Inclusion of studies Study population selection Comparability of results Evaluation of outcomes
Loukil et al.16 *** ** **
Gillissen et al.17 **** ** **
Lin et al.18 ** ** **
Li et al.19 ** ** ***
Takaku et al.20 *** ** **

Clinical characteristics of included trials.

Inclusion of studies Type of study Country Percentage of women (%) Age (years) mean (+SD/range) Total number of people (n) Type of inhaler used
Loukil et al16 Cohort Spanish 48.2 47.4 ± 16.3 54 DPI
Gillissen et al.17 Cohort Germany 44.6 65.6 ± 11.6 1236 DPI
Lin et al18 Cohort China 36.8 67 ± 15 136 DPI, MDI
Li et al.19 Cohort China 33.1 64 (47–81) 384 DPI
Takaku et al.20 Cohort Japan 9.0 72 ± 7 81 MDI, DPI
Ngo et al21 Cross-sectional Vietnam 7.0 68.6 ± 8.7 70 MDI, DPI, SMI
Bournival et al.22 Cross-sectional Canada 49.0 69.8 ± 8.3 98 DPI, SMI
Al Ammari et al.23 Cross-sectional Saudi Arabia 48.9 58.4 ± 17.9 40 MDI
Castel-Branco et al.24 Cross-Sectional Portugal 49.3 65.4 ± 18.38 95 DPI, MDI, SMI
Pothirat et al.8 Cross-sectional Thailand 35.9 71.2 ± 9.2 103 DPI, MDI, SMI
Ding et al.25 Cross-sectional America 48.0 Men: 59.8 ± 10.2; Women: 60.7 ± 7.8 61 MDI, SMI
Press et al.26 Cross-Sectional America 58.6 59.2 29 MDI
Oliveira et al.27 RCT Brazil 44.0 63.5 ± 8.2 140 DPI, SMI
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