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A new, modified form of inhaler ('Rotahaler') for patients with chronic obstructive lung disease.

A randomized study was carried out in 396 patients requiring inhalation therapy for chronic obstructive lung disease to assess whether a modified, breath-activated device for drug delivery ('Rotahaler') was more effective than the current standard model in opening the hard gelatin cartridge containing the drug in powder form ('Rotacaps'). 'Rotacaps' packaged in two different ways, one specially designed to protect them against environmental changes, were also compared. Patients were asked to open 5 cartridges of each type with each of the two devices. The modified 'Rotahaler' failed to open only 0.7% of both types of 'Rotacaps' whereas the standard model failed to open 13.6% of the foil-packed type and 16.9% of those from a special polypropylene container. There was a statistically significant difference between the two 'Rotahaler' devices and between the two types of 'Rotacaps' in the standard device. More patients preferred the modified 'Rotahaler' (160) than the standard (75). The results did not depend upon age, sex, nationality of the patients or previous 'Rotahaler' experience. It is concluded that the modifications substantially improve the performance of the 'Rotahaler' and should make it easier for patients to use.