New research from by Dr. Bryan Ross, Dr. Jean Bourbeau, and his research team shows that nearly one in three people with chronic obstructive pulmonary disease (COPD) may be using inhalers that aren’t suited to their breathing strength. The study, published in CHEST, highlights the importance of measuring peak inspiratory flow (PIF)—a simple test that gauges how strongly a person can inhale. Without enough inhalation force, some inhalers may not deliver medication effectively. The researchers found that suboptimal PIF was especially common among women, with nearly half of female participants affected, compared to just 8% of men.
By routinely assessing PIF in clinical settings, healthcare providers could better match inhalers to a patient’s physical capacity, improving treatment outcomes and reducing the risk of exacerbations (a sudden worsening of respiratory symptoms). The study also found that patients prescribed multiple inhaler types with different instructions may face confusion or improper use. This work points to a straightforward way to personalize COPD care. A follow-up study, CAN-EXACT (the Canadian Exacerbations of COPD Trial), is now underway to track PIF changes over time in patients with COPD to better understand how PIF fluctuations relate to clinical outcomes, including the frequency and severity of exacerbations.
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Better breathing, better treatment for COPD. New research from researchers at The Institute finds that nearly a third of patients with COPD are at risk of using inhalers ill-suited to their breathing strength—highlighting a simple test that could improve care. The Institute News. June 2, 2025
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Peak Inspiratory Flow and Inhaler Prescription Strategies in a Specialized COPD Clinical Program: A Real-World Observational Study. Pankovitch S, Frohlich M, AlOthman B, Marciniuk J, Bernier J, Paul-Emile D, Bourbeau J, Ross BA. Chest. 2025 Mar;167(3):736-745