So why aren’t they used more widely?
A new review suggests that wider use of OPEP devices could reduce exacerbations and reduce hospital visits.
London, ON - Many COPD patients have an on-going cough due to built up mucus, impaired cilia, and other aspects of their condition.1 Shortness of breath, activity limitation and recurring respiratory infections can all result from damaged airways and an ineffective cough that does not expel the excess mucus.1 Although inhaled therapies are the cornerstone of treatment, evidence shows that non-pharmaceutical therapies such as pulmonary rehabilitation, self-management intervention to increase patient’s adherence to medical therapy and to facilitate implementation of healthy behaviours should be part of the optimal management of COPD patients. For non-pharmacological therapies, little or no attention has been given to oscillating positive expiratory pressure (OPEP) devices such as the Aerobika* device for their effectiveness and use in clinical practice.
“Short term use of OPEP devices can reduce moderate-to-severe COPD exacerbations, leading to reduced rehospitalizations and ER visit."
Working with the lungs’ natural response
The Aerobika* device is a small, hand held, drug-free unit which uses the patient’s exhaled breath to create pressure and vibrations in the airways, stenting open the airway, and thinning and loosening the mucus. With oscillations that resonate at a frequency similar to cilia and the resulting changes in the airway, the thick, sticky mucus, moves up into the upper airways where it can be removed by coughing/”huffing” techniques.1 “Short term use of OPEP devices can reduce moderate-to-severe COPD exacerbations, leading to reduced rehospitalizations and ER visit. The Aerobika* device has also been shown to improve health-related quality of life and exercise capacity in sputum producers with COPD (chronic bronchitis patients) compared to non-sputum producers.”, says Respirologist Dr. Jean Bourbeau, (Director COPD clinic and Pulmonary Rehabilitation, Montreal Chest Institute) “Given that COPD has the highest rate of hospital admissions among major chronic illnesses in Canada, combining pharmacological and non-pharmacological therapy should be considered.”
Efficacy shown in a real world study
The effectiveness of the Aerobika* device in COPD treatment was recently included in a comprehensive review, analyzing 20 years of data.1 One retrospective study measured the rate of moderate-to-severe exacerbations and related costs in 405 COPD patients using the Aerobika* device versus a matched control group (n=405, no OPEP device) in a real-world setting. At 30 days, significantly fewer patients using the Aerobika* device experienced moderate-to-severe exacerbations compared to the non-treated group.2 Fewer exacerbations were associated with an observed decrease in the rates of hospitalization and ER visits, resulting in reduced hospital costs.1
The economic burden of COPD is significant, so any therapies that can alleviate symptoms and reduce exacerbations are critical to patients and the healthcare system.1 “When combined with medications, non-pharmacological approaches have the potential to be a safe and effective addition to the care pathway,” says Dr. Bourbeau. “This review highlighted the benefit of specific devices in the management of COPD and suggests the need for a greater visibility of OPEP therapy in COPD guidelines and care pathways. However, the review also highlighted areas where more research should be done, for example on the use of OPEP devices combined with pulmonary rehabilitation.
For clinical inquiries, please contact:
Jason Suggett PhD, BPharm, MBA, MRPharmS
Group Director of Global Science and Technology
See study the full study
1. Bourbeau J, Kaplan A, McIvor A, Devlin H. Oscillating positive expiratory pressure (OPEP) device therapy in Canadian respiratory disease management: Review,care gaps and suggestions for use. CANADIAN JOURNAL OF RESPIRATORY, CRITICAL CARE, AND SLEEP MEDICINE https://doi.org/10.1080/24745332.2018.1558426
2. Burudpakdee C, Seetasith A, Dunne P, et al. A real-world study of 30-day exacerbation outcomes in chronic obstructive pulmonary disease (COPD) patients managed with Aerobika_ OPEP. Pulm Ther. 2017;3(1):163–171. https://link.springer.com/article/10.1007%2Fs41030-017-0027-5