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Information for
Healthcare Professionals

The burden of chronic respiratory conditions

Asthma & Chronic Obstructive Pulmonary Disease (COPD)
Amongst the most common chronic respiratory conditions, these two contribute considerably to the population’s disease burden.1

Asthma
  • In 2017-18, 2.7 million Australians had asthma2 – around 11% of the population.2
  • In 2020-21, there were 25,000 hospitalisations where asthma was the principal diagnosis.3
  • In 2020, there were 417 deaths due to asthma.4
COPD
  • As of 2023, around 1 in 13 Australians aged 40 years and over have some form of COPD.5
  • In 2020-21, approximately 53,600 Australians (>45 years) were hospitalised where COPD was the principal diagnosis.6
  • 5th leading cause of death in Australia in 2020.7

Clinical guidelines recognise the benefits of spacers

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Pressurised metered-dose inhalers (pMDI) should be used with a spacer device, as some people have difficulty coordinating the release of medication with inhalation.8

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Spacers should be used by9

  • all children
  • all adults taking a corticosteroid preventer medication using an MDI [Metered Dose Inhaler]
  • adults who have trouble coordinating the ‘press and breathe’ technique
  • anyone taking a reliever medication during an asthma attack
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Using a spacer with a pressurised metered dose inhaler (pMDI) will help improve delivery of the medication into the airways.10

Improved Drug Delivery

Pressurised metered dose inhalers tend to be used sub-optimally.11 Most pMDIs only deliver 1/5 of medication into the lungs when used alone.12,13

A spacer increases drug delivery to the lower airways deep within the lungs

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  • *Results based on laboratory tests on emitted dose of salbutamol sulfate 100ug and may not be indicative of clinical performance. P-value not available.
  • Spacer use can result in less medication ending up in the oropharynx reducing adverse effects such as oral candidiasis11,13

Yet a spacer was used by only 14% of asthma patients
and 41% of COPD patients
who used a pMDI.15†
† Based on observational study n=103

Breath-A-Tech® spacers, creating more than just a spacer

spacer-diagram

The Breath-A-Tech® Anti-static Spacer is a hand-held, portable valved holding chamber (VHC), that is placed between a pressurised metered dose inhaler (pMDI) and the patient’s mouth, to function as a reservoir from which an aerosol medication is dispensed in order to minimise delivery of large aerosolised particles.

Warning: Always follow the directions for use.

anti-static-iconAntistatic properties, no priming required16

Deposition of medication on inner surface of face mask
  • One known cause of variable dose delivery from spacers and face masks is static charge.17
  • Spacers and face masks that are highly charged with static forces deliver less drug compared to those spacers with an antistatic coating.17
  • The Breath-A-Tech® spacers contains a glycerol fatty acid ester which conveys antistatic properties to the polypropylene material.18
  • Breath-A-Tech® spacer combination packs also offer antistatic silicone face mask options.16
  • Unlike non-antistatic spacers, Breath-A-Tech® Anti-static spacers and the Anti-static face mask can be used straight out of the box, without the need for priming or washing before first use.16
  • Breath-A-Tech® Anti-static spacer and Anti-static face mask combination delivers a full antistatic journey of medication from pMDI to the lungs.16

Figure 1: One actuation of salbutamol 100 μg pMDI was delivered through valved holding chambers (VHCs) and large size face masks at a constant inspiratory flow of 30L/min. Results based on laboratory tests and may not be indicative of clinical performance

cross-valve-iconCross Valve Technology™

anti-static-icon

Valve opens upon inhalation

Valve closes upon exhalation

Provides assurance that medication is being inhaled correctly

Breath-A-Tech® spacers contain a one-way valve behind the mouthpiece which is based on Cross Valve Technology™

The Cross Valve Technology™22

  • Features a robust designed valve that works effectively when the spacer is held at different angles.
  • Ensures a very low resistance when inhaling your medication.
  • Allows you to easily breathe out through the spacer.
  • Prevents exhaled breath from re-entering the chamber.

Increase respirable dose delivery to the lungs11

increase-fine-particle-graph increase-fine-particle-graph

‡Figure 2: Results of the aerodynamic particle size distribution study of salbutamol 100ug, performed in the laboratories of Medical Developments International, using a Next Generation Impactor (NGI) at a constant flow rate of 15L/min (child) and 30L/min (adult), simulating fully-coordinated (optimal) use.14

Decrease oropharyngeal deposition20

decrease-oropharyngeal-graph decrease-oropharyngeal-graph

§Figure 3: Results of the aerodynamic particle size distribution study of fluticasone propionate (FP) 100 ug, performed in laboratories of Medical Developments International, using a Next Generation Impactor (NGI) at a constant low rate of 30L/min, simulating fully-coordinated (optimal) use.

Key messages
  • Asthma & COPD contribute considerably to the population’s disease burden.1
  • Clinical guidelines state a pMDI should be used with a spacer device, yet only 14% of asthma patients and 41% of Chronic Obstructive Pulmonary Disease patients use a spacer.9,15
  • Breath-A-Tech® spacers increase the delivery of the drugs respirable fraction and decrease coarse particle deposition.14
References
  1. Australian institute of Health and Welfare. (2017) The burden of chronic respiratory conditions in Australia) [ONLINE] Available at https://www.aihw.gov.au/reports/burden-of-disease/burden-chronic-respiratory-conditions/contents/summary (Accessed: 2 February 2023).
  2. Australian Institute of Health and Welfare (2023). Chronic Respiratory Conditions [ONLINE] Available at: https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-respiratory-conditions/overview (Accessed: 2 May 2023).
  3. Australian Institute of Health and Welfare. (2023) Asthma [ONLINE] Available at: https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-respiratory-conditions/overview (Accessed: 23 May 2023).
  4. National Asthma Council Australia. (2021) Asthma deaths remain stubbornly high in Victoria [ONLINE] Available at: https://www.nationalasthma.org.au/news/2021/asthma-deaths- (Accessed: 2 February 2023).
  5. Lung Foundation Australia. Overview Chronic Obstructive Pulmonary Disease [ONLINE] Available at: https://lungfoundation.com.au/patients-carers/living-with-a-lung-disease/copd/overview/#:~:text=Around%201%20in%207%20Australians,than%20non%2DIndigenous%20Australians4 (Accessed: 02 May 2023)
  6. Australian Institute of Health and Welfare (AIHW) [ONLINE] Available at: https://www.aihw.gov.au/reports/chronic-respiratory-conditions/chronic-respiratoryconditions/ contents/chronic-obstructive-pulmonary-disease ( Accessed March 2023)
  7. Australian Institute of Health and Welfare. (2020) Chronic obstructive pulmonary disease (COPD) [ONLINE] Available at: https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-respiratory-conditions/overview
  8. World Health Organisation. (2022) Asthma. [ONLINE] Available at: https://www.who.int/news-room/fact-sheets/detail/asthma (Accessed: 2 February 2023).
  9. National Asthma Council Australia (2018) Spacer Use and Care Factsheet [ONLINE] Available at: https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/spacer-use-and-care (Accessed: 24 March 2023)
  10. Lung Foundation Australia. Inhaler Technique. [ONLINE] Available at: https://lungfoundation.com.au/patients-carers/after-your-diagnosis-title/inhaler-devices/ (Accessed: 2 February 2023).
  11. Vincken, W., Levy, M., Scullion, J., Usmani, O., Dekhuijzen, P., & Corrigan, C. (2018). Spacer devices for inhaled therapy: why use them, and how?. ERJ Open Research, 4(2).
  12. Newman SP. Drug delivery to the lungs: challenges and opportunities. Ther Deliv. 2017 8(8):647- 661.
  13. Godara, N., Khullar, M., & Godara, R. (2011). Impact of inhalation therapy on oral health. Lung India, 28(4), 272.
  14. Data on File – Internal Test Report RD116 (2020)
  15. Bryant L, Bang C, Chew C, et al. . Adequacy of inhaler technique used by people with asthma or chronic obstructive pulmonary disease. J Prim Health Care 2013; 5: 191–198
  16. Breath-A-Tech. Antistatic Spacer Chamber Instructions for Use (IFU).
  17. Barry, P., & O’Callaghan, C. (1999). The output of budesonide from spacer devices assessed under simulated breathing conditions. Journal Of Allergy And Clinical Immunology, 104(6), 1205-1210.
  18. Data on file. Tegin 90 Antistatic Agent – Technical Information
  19. 19. Data on file. RD036.
  20. Toogood JH, Baskerville J, Jennings B, Lefcoe NM, Johansson SA. Use of spacers to facilitate inhaled corticosteroid treatment of asthma. Am Rev Respir Dis. 1984 May;129(5):723-9.
  21. Yang IA, George J, McDonald CF, McDonald V, O’Brien M, Smith B, Zwar N, Dabscheck E. The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2021. Version 2.63, Feb 2021.
  22. Cross Valve TechnologyTM – Data on file