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Sakaan S, Ulrich D, Luo J, et al. Inhaler Use in Hospitalized Patients with Chronic Obstructive Pulmonary Disease or Asthma: Assessment of Wasted Doses. Hosp Pharm. 2015;50(5):386-90doi: 10.1310/hpj5005-386.
Sakaan, S., Ulrich, D., Luo, J., Finch, C. K., & Self, T. H. (2015). Inhaler Use in Hospitalized Patients with Chronic Obstructive Pulmonary Disease or Asthma: Assessment of Wasted Doses. Hospital pharmacy, 50(5), 386-90. https://doi.org/10.1310/hpj5005-386
Sakaan, Sami, et al. "Inhaler Use in Hospitalized Patients with Chronic Obstructive Pulmonary Disease or Asthma: Assessment of Wasted Doses." Hospital pharmacy vol. 50,5 (2015): 386-90. doi: https://doi.org/10.1310/hpj5005-386
Sakaan S, Ulrich D, Luo J, Finch CK, Self TH. Inhaler Use in Hospitalized Patients with Chronic Obstructive Pulmonary Disease or Asthma: Assessment of Wasted Doses. Hosp Pharm. 2015 May;50(5):386-90. doi: 10.1310/hpj5005-386. PMID: 26405325; PMCID: PMC4567205.
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Hosp Pharm. 2015 May;50(5):386-90. doi: 10.1310/hpj5005-386.

Inhaler Use in Hospitalized Patients with Chronic Obstructive Pulmonary Disease or Asthma: Assessment of Wasted Doses.

Hospital pharmacy

Sami Sakaan, Dagny Ulrich, Jenny Luo, Christopher K Finch, Timothy H Self

Affiliations

  1. Clinical Pharmacist, Methodist University Hospital , Memphis, Tennessee.
  2. University of Tennessee Health Science Center , Memphis.
  3. Assistant Director, Clinical Pharmacy Services, Methodist University Hospital , Memphis, Tennessee ; Associate Professor of Clinical Pharmacy, University of Tennessee Health Science Center , Memphis.
  4. Professor of Clinical Pharmacy, University of Tennessee Health Science Center , Memphis ; Program Director, PGY2 Internal Medicine Pharmacy Residency, Methodist University Hospital , Memphis, Tennessee.

PMID: 26405325 PMCID: PMC4567205 DOI: 10.1310/hpj5005-386

Abstract

BACKGROUND: Hospitalized patients with chronic obstructive pulmonary disease (COPD) or asthma routinely have inhaled medications ordered for acute and maintenance therapy. Treatment may be administered via metered-dose inhaler (MDI) or dry-powder inhaler (DPI). These products must be appropriately labeled to be released home with the patient or discarded before discharge.

OBJECTIVE: To assess the amount and estimated cost of wasted doses of medications via MDI or DPI for hospitalized patients with COPD/asthma.

METHODS: A retrospective study was conducted at a university-affiliated hospital. Patients admitted between January 2011 and June 2012 with a primary diagnosis of COPD or COPD with asthma and who were ≥40 years of age were included. Information collected included use of albuterol, ipratropium, inhaled corticosteroids, long-acting beta agonist, or tiotropium and whether treatments were given by nebulizer, MDI, MDI plus valved holding chamber (VHC), or DPI. The number of doses dispensed, as well as doses not used, via MDI, MDI + VHC, or DPI were collected from electronic medical records. Costs associated with wasted medications were evaluated.

RESULTS: Of 555 patient admissions screened, 478 (mean age, 66 years; 58% women; 74% African American) met study criteria. Of the total MDI or DPI doses dispensed, 87% were wasted, and associated hospital cost was approximately $86,973.

CONCLUSIONS: Substantial waste of inhaled medications was found in our study. Practical strategies are needed to reduce wasted inhalers. Further assessment of this problem is needed in other US hospitals.

Keywords: hospitalized COPD patients; inhalers; waste

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