Assessment of Patient Satisfaction and Preferences With Inhalers in Asthma With the FSI-10 Questionnaire

Background and objectiveLack of adherence to inhaled corticosteroid therapy is common in patients with asthma, and it has been suggested that allowing patients to choose their own inhalers would resolve this problem. The FSI-10 (Feeling of Satisfaction with Inhaler) is a self-completed questionnaire to assess patient opinions regarding ease or difficulty of use, portability, and usability of devices for delivery of inhaled corticosteroids. The aim of this study was to define the measurement properties of the FSI-10 questionnaire and to use this inventory to compare satisfaction and preferences of patients with asthma regarding 3 different devices for delivery of inhaled corticosteroids: Turbuhaler, Accuhaler, and Novolizer.Patients and methodsWe performed a multicenter, prospective, observational study in 112 stable asthmatic patients (64 women; mean [SD] age, 37 [22] years) treated on a regular basis with inhaled corticosteroids. The use of the devices was explained to the patients and the order in which they should be used in each case was randomly assigned. The devices were used for 7-day periods and at the end of each the FSI-10 questionnaire was completed for the device used. Once the protocol was completed, patients stated their preference for the different devices used.ResultsThe FSI-10 was easily understood and rapidly completed, and it exhibited acceptable measurement properties. Factor analysis showed that the measure was unidimensional. Although acceptance of all 3 devices assessed was reasonable, the FSI-10 questionnaire detected significant differences between them: Turbuhaler and Novolizer scored higher than Accuhaler on a number of questions. This preference is partly explained by Turbuhaler having been the device that was commonly used by the patients prior to the study. However, the highest scoring and most often preferred inhaler in patients under 16 years of age was the Novolizer, even though the Turbuhaler had also usually been used by those patients prior to the study.ConclusionsThe FSI-10 is a useful instrument for assessing the degree of satisfaction of asthmatic patients regarding available inhalation devices. It is easy to understand and complete, and able to identify differences in patient satisfaction with the different inhalers.

Antecedentes y objetivoEl incumplimiento terapéutico con los corticoides inhalados (CI) es frecuente en los pacientes con asma. Se ha señalado que la elección del dispensador por el paciente facilitaría la solución del problema. El FSI-10 (Evaluación de la Satisfacción con el Inhalador) es un cuestionario autorrellenable que valora las opiniones sobre comodidad, dificultad, transportabilidad y manejabilidad de los dispositivos para CI. El objetivo de este trabajo ha sido definir las propiedades métricas del FSI-10 y comparar, mediante este inventario, la satisfacción y las preferencias de los pacientes con asma respecto a 3 dispositivos para CI: Turbuhaler® (T), Accuhaler® (A) y Novolizer® (N).Pacientes y métodosHemos realizado un estudio observacional, prospectivo y multicéntrico en 112 asmáticos (64 mujeres; edad media ± desviación estándar: 37 ± 22 años) estables y tratados regularmente con CI. Se les explicó la técnica de utilizatión de los dispositivos a evaluar y, aleatoriamente, se asignó el orden en que debían emplearlos. Usaron los dispositivos durante períodos de 7 días, tras los cuales cumplimentaron el FSI-10. Completado el protocolo, todos ellos expresaron el grado de preferencia por los dispositivos empleados.ResultadosEl FSI-10 resultó fácil de comprender y rápido de cumplimentar, y mostró propiedades métricas aceptables. El analisis factorial exploratorio muestra la unidimensionalidad de la medida. La aceptacion de los 3 dispositivos evaluados fue razonable, pero el FSI-10 detect» diferencias signiflcativas entre ellos: los sistemas T y N se valoraron mejor que A en bastantes preguntas del cuestionario. Esta pre-ferencia responde en parte al hecho de que T era el dispositi-vo comunmente utilizado con anterioridad por los pacientes. Sin embargo, para los menores de 16 afios el inhalador prefe-rido y mejor puntuado fue N, a pesar de que en este subgrupo tambien era el T el habitualmente manejado.ConclusionesEl FSI-10 es un instrumento util para evaluar el grado de satisfaction del paciente asmatico con los dispositivos de inhalacion disponibles. Es comprensible, de facil manejo y capaz de identificar diferencias de satisfaccion entre distintos inhaladores.