Abstract
We present an extensive review of the literature to date pertaining to the rationale for using a spacer/valved holding chamber (VHC) to deliver inhaled therapy from a pressurised, metered-dose inhaler, a discussion of how the properties of individual devices may vary according to their physical characteristics and materials of manufacture, the potential risks and benefits of ancillaries such as valves, and the evidence that they contribute tangibly to the delivery of therapy.
We also reiterate practical recommendations for the correct usage and maintenance of spacers/VHCs, which we trust offer practical help and advice to patients and healthcare professionals alike.
Abstract
Every patient treated with a pMDI should own and regularly use a spacer/VHC, and know how to use it properly, both for routine preventer therapy and in an emergency, and how to keep it clean and keep an eye out for faults http://ow.ly/EDs730keDOw
Footnotes
Author contributions: All of the authors contributed to researching, collating and writing this paper. W. Vincken led the literature search and collated the findings. M.L. Levy also checked and formatted the references appropriately. J. Scullion, O.S. Usmani and P.N.R. Dekhuijzen also paid particular attention to the clinical protocols. C.J. Corrigan was also responsible for the final layout and wording of the manuscript.
Conflict of interest: M.L. Levy reports receiving consultancy fees from Clement Clarke International, and personal fees for lectures and conference accommodation from Teva and AstraZeneca, is a board member of the Global Initiative for Asthma (GINA), and has received reimbursement for travel and accommodation expenses from GINA, has received funding from Chiesi for the DSMB, Triple, Forward, Trigger and Trimeran studies, and accommodation support from Chiesis to attend the ERS International Congress in 2017, has received an education grant from Consorzio Futuro in Ricerca for the ADMIT group, attended advisory board meetings with AstraZeneca in January 2018 and with Boehringer Ingelheim in November 2017, and has received lecture fees from Soar Beyond outside the submitted work.
Conflict of interest: J. Scullion reports receiving honoraria for attending meetings from AstraZeneca, Chiesi, Teva, Boehringher Ingelheim, Pfizer, Mylan, Trudell, Nutricia and Sandoz, and support for a meeting from Roche, outside the submitted work.
Conflict of interest: C.J. Corrigan reports attending an open day at GlaxoSmithKline headquarters, outside the submitted work.
Support statement: The Aerosol Drug Management Improvement Team (ADMIT) is a group of European respiratory physicians with a common interest in promoting excellence in the delivery of inhaled drugs for asthma and COPD. It is supported by an unrestricted educational grant from the Consorzio Futuro In Ricerca. Members of ADMIT receive compensation for attending meetings.
- Received May 9, 2018.
- Accepted May 18, 2018.
- Copyright ©ERS 2018
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.