Many of your patients with ongoing symptoms of COPD may be candidates for nebulized therapy

Patients should be reassessed at every opportunity3,8-10

Have you seen patients like us in your practice?

The relationship between patient conditions, device type, and medication efficacy has not been established.

Not an actual patient.

“I struggle
with my inhalers.”

-Robert

Not an actual patient.

“I have impaired
inspiratory flow.”

-Maria

Not an actual patient.

“Susan is experiencing
cognitive decline.”

-Susan’s husband and caregiver

Not an actual patient.

“I am transitioning from
hospital to home care.”

-Ken

Not an actual patient.

“I’m using my short-acting
bronchodilator, but my
symptoms are still getting worse.” -Diane 

Have you considered the role of nebulization in COPD maintenance therapy?

Nebulizers: a user-friendly option for COPD patients2

  • Nebulizers require only normal tidal breathing and do not require extra effort to generate adequate inspiratory force3-5
  • No hand-breath coordination is needed3,6
  • Today’s nebulizers include compact, portable, and low-cost options for most patients7,20

Are your patients able to use their devices properly?

Percent of patients reporting they were very confident about medication delivery by device type3

delivery by device type
  • Small-Volume Nebulizers
  • Soft-Mist Inhalers
  • Metered-Dose Inhalers
  • Dry-Powder Inhalers
  • 100%
  • 80%
  • 60%
  • 40%
  • 20%
  • 0%
delivery by device type

Selected responses from a 127-question, quantitative, web-based, descriptive, cross-sectional survey of 499 patients with COPD in the United States. Survey participants were aged 55 to 74 years, predominantly former smokers, and were randomly chosen from a panel of individuals with self-identified COPD.

  • 61% to 69% of patients believed that they used their device correctly all the time; patients using small-volume nebulizers were the most confident3

Jet nebulizers are commonly available2

  • Jet nebulizers are considered standard among all nebulizer types2
  • Most are 100% covered as durable medical equipment (DME) through Medicare Part B19

This is not a guarantee of coverage. Site of Care will determine coverage. Check with your patient’s insurance provider for coverage rules and restrictions. In certain limited instances, YUPELRI may be covered through a patient’s Medicare Part D pharmacy benefit.

Among COPD patients in the United States:

~45%

have a nebulizer at home

†These data are referenced from a 2008 survey.

Based on the estimated prevalence of COPD in the US, several million patients use nebulizers on a regular basis4

Not an actual patient

Over half of COPD patients 45+ years are likely to have coexisting arthritis.  12

Robert struggles with using his inhaler*

  • 65-year-old male
  • Married; retired, but helps care for his 2 grandchildren 5 days a week

“I try to use my inhalers every day like my doctor told me to, but it’s hard to use the inhaler properly. It feels like my symptoms are getting worse.” -Robert

44% of COPD patients self-reported having arthritis. Arthritis or other manual dexterity issues may prevent patients from using inhaler devices properly. Other conditions to be aware of which may limit somebody’s physical ability to use an inhaler include poor coordination, neuromuscular conditions, etc.3,*

Presentation

  • FEV1 ≈50% predicted
  • GOLD Group E
  • Symptomatic, with worsening morning cough and shortness of breath
  • Expresses concern with ability to use his inhalers

Medical history

  • Former smoker, 23-pack-year history
  • Diagnosed with COPD 10 years ago
  • Comorbid condition: Osteoarthritis with poor hand-grip strength

Current COPD treatments

  • Handheld maintenance inhaler
  • Handheld rescue inhaler

Treatment goal

  • Seeks a different way to take his maintenance treatment so he can feel more confident in his therapy
*The relationship between patient conditions, device type, and medication efficacy has not been established.
Not an actual patient

Approximately 19% of patients with advanced COPD and ≥60 years of age have impaired inspiratory effort.  13

Maria has impaired inspiratory flow*

  • 61-year-old female
  • Married, works full-time as an administrative assistant
  • Tries to walk for 20 minutes, 5 days a week, but doesn’t always meet this goal

“I use my maintenance inhalers every day, but I’m still out of breath when I walk. So I’ve been using my rescue medication a lot, which worries me.”-Maria

Inspiratory flow is one of many factors to consider when choosing a delivery device.14

Presentation

  • Hospitalized FEV1 ≈73% predicted
  • GOLD Group B
  • Symptomatic, experiencing exertional dyspnea

Medical history

  • Former smoker, 15-pack-year history with strong secondhand smoke exposure from both parents as a child

Current COPD treatments

  • Handheld maintenance inhaler
  • Nebulized rescue therapy

Treatment goal

  • Desires reliable symptom control
*The relationship between patient conditions, device type, and medication efficacy has not been established.
Not an actual patient

As many as one-third of COPD patients were classified as having either borderline or impaired cognitive functioning.  15,16,17†

Susan is experiencing cognitive decline*

  • 75-year-old female
  • Married; mother and grandmother
  • Mild dementia

“Making sure Susan takes her medicine properly can be a challenge—I wish she could use one type of device where she doesn’t need to coordinate her breath.” -Susan’s husband and caregiver

Cognitive impairments in COPD patients are a common barrier to correct inhaler device administration. It is important to consider the role of the caregiver in the assessment of cognitive decline.3,8,15,*

Presentation

  • FEV1 ≈45% predicted
  • GOLD Group E
  • Symptomatic, with shortness of breath, fatigue, and disrupted sleep

Medical history

  • Former smoker, 20-pack-year history
  • Diagnosed with COPD 14 years ago
  • Comorbid condition: Mild dementia

Current COPD treatments

  • Handheld maintenance inhaler
  • Nebulized rescue therapy

Treatment goal

  • Caregiver expresses need for simplified delivery, requiring less hand-breath coordination
*The relationship between patient conditions, device type, and medication efficacy has not been established.
†On tests measuring psychomotor speed and executive control functioning.
Not an actual patient

Only 6% of patients with severe COPD used their inhaler therapy regularly and with correct technique a majority of the time in the month following hospital discharge. 15,*

Ken is transitioning from hospital to home care*

  • 68-year-old male
  • Retired; lives alone, but has an active social life

“I keep ending up back in the hospital and don’t feel in control of my COPD. I lack confidence going home without a nebulizer.”-Ken

It is critical for patients to be assessed for medication and device technique before leaving the hospital.8,16

Presentation

  • Hospitalized due to an acute exacerbation of COPD
  • FEV1 ≈46% predicted
  • GOLD Group E
  • Chronic nonproductive cough, shortness of breath, and wheezing at admission

Medical history

  • Former smoker, 29-pack-year history
  • Diagnosed with COPD 12 years ago
  • Third exacerbation in the past 12 months

Current COPD treatments

  • Preadmission: Using handheld maintenance and rescue inhalers
  • During admission: Stabilized and transitioned to nebulized maintenance and rescue therapies

Treatment goal

  • Desires one type of delivery system while maintaining symptom control
*The relationship between patient conditions, device type, and medication efficacy has not been established.
Not an actual patient

Many COPD patients are undertreated, and over half do not receive the GOLD recommended maintenance medications.  17,18

DIANE is experiencing worsening of symptoms on her short-acting bronchodilator*

  • 65-year-old female
  • Married; retired, but helps care for her 3 grandchildren 3 days a week

“I like taking my COPD medication through a nebulizer, but I am now taking my medicine more frequently, at 4 to 6 times a day. It's tough to do the things I used to do.” -Diane

Patients experiencing a worsening of symptoms on their current therapy may need to be reassessed.14

Presentation

  • FEV1 ≈70% predicted
  • mMRC: Grade 3; CAT: 10
  • GOLD Group B
  • Symptomatic, with difficulties walking without stopping to catch her breath. Three months since her last visit with her doctor, her cough has worsened, and she has increased sputum production leading to chest tightness as well as a lack of energy, which is related to her COPD
  • Expresses concern with worsening of symptoms

Medical history

  • Former smoker, 20-pack-year history with strong secondhand smoke exposure from husband who also smoked
  • Diagnosed with COPD 10 years ago
  • Comorbid condition: Osteoarthritis with poor hand-grip strength

Current COPD treatments

  • Nebulized short-acting bronchodilator

Treatment goal

  • Prefers nebulization and desires reliable symptom control
*The relationship between patient conditions, device type, and medication efficacy has not been established.