Comparison of Efficacy of Metered Dose Inhaler and Dry Powder Inhalation in Treatment of Persistent Asthma

Abstract

Objective: To compare the efficacy of dry powder inhaler versus metered dose inhaler for control of persistent asthma in terms of a mean difference of 500 ml improvement in FEV1 amongst the two groups. Study design: It was Randomized Controlled Trial. Settings: The study was conducted in Medicine Department, Services Hospital, Lahore. Duration: From October 19, 2017 to April 19, 2018. Methodology: A total of 458 patients who fulfilled the inclusion criteria were enrolled in the study. 229 patients in each group were divided using lottery method into two groups (Group-A & Group-B). Metered Dose Inhaler was given to group-A patients for 4 weeks. Dry Powder Inhaler was given to group-B patients for 4 weeks. Follow up by 4th week was done by patient’s outdoor visits by doing pulmonary function tests and measuring forced expiratory volume 1 second. All the collected information was transferred to SPSS v23.0 and analyzed accordingly. Data were stratified for gender, age and duration of disease to address the effect modifiers. For post-stratification, Chi-Square test was used taking p-value ≤0.05 as significant. Results: A total of 458 patients with asthma were examined in this study. Patients were randomly divided in two groups i.e. Group-A (Metered Dose Inhaler) and Group-B (Dry Powder Inhaler). Efficacy was found in 162(70.7%) patients in group-A (Metered Dose Inhaler) while in 126(55.0%) patients in group-B (Dry Powder Inhaler) with a p-value as 0.0004 which was statistically significant. Conclusion: Metered Dose Inhaler (MDI) provides significant improvements in FEV1 versus Dry Powder Inhaler (DPI)