Many of your uncontrolled COPD patients may be candidates for nebulized therapy
Patients should be reassessed at every opportunity3,8-10
Have you seen patients like us in your practice?
I struggle with
my inhalers.
-Robert
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.
Over half of COPD patients 45+ years are likely to have coexisting arthritis.12
44% of COPD patients self-reported having arthritis. Arthritis or other manual dexterity issues may prevent patients from using inhaler devices properly.3,†

Presentation
- FEV1 ≈50% predicted
- GOLD Group C
- 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
I have insufficient inspiratory force.
-Maria
Maria has suboptimal inspiratory force*†
- 61-year-old female
- Married, works full-time as an administrative assistant
- Tries to walk for 30 minutes, 5 days a week, but doesn’t always meet this goal
I use my maintenance inhaler 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.
Approximately 19% of patients with advanced COPD and ≥60 years of age have impaired inspiratory effort.13
Inspiratory flow is an important factor 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
I am transitioning from hospital to home care.
-Ken
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 need a change.
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,†
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 C
- 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 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
Susan is experiencing cognitive decline.
-Susan’s husband and caregiver
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 just one type of device where she doesn’t need to coordinate her breath. —Susan’s husband and caregiver
As many as one-third of COPD patients were classified as having either borderline or impaired cognitive functioning.15,16,17‡
‡On tests measuring psychomotor speed and executive control functioning.
Cognitive impairments in COPD patients are a common barrier to correct inhaler device administration.3,8,15,,†

Presentation
- FEV1 ≈45% predicted
- GOLD Group C
- 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
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 generating adequate inspiratory force rate3-5
- 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

- Small-Volume Nebulizers
- Soft-Mist Inhalers
- Metered-Dose Inhalers
- Dry-Powder Inhalers
- 100
- 80
- 60
- 40
- 20
- 0
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 availabless 2
- 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*
Based on the estimated prevalence of COPD in the US, several million patients use nebulizers on a regular basis4