Patient Centered Considerations when Selecting an Oscillating Positive Expiratory Pressure (OPEP) Device

Efficacy is a major aspect when selecting an OPEP device for airway clearance.

However, usability of the device is also another very important aspect to consider in device selection as this may affect adherence to the therapy.

This study compares patient use factors for several different OPEP devices (covering design improvements introduced over time) with the aim of highlighting usability differences, as it may help with device selection.

This study was presented at the North American Cystic Fibrosis Conference 2022.

Four different OPEP devices were evaluated. These were:

1. Aerobika^®(Monaghan Medical) 2. Acapella Choice Blue† (Smiths Medical) 3. Flutter† and similar (multiple manufacturers – e.g. Pari OPEP, AirPhysio, Gelomuc†) 4. vPEP† (DR Burton). Previous studies have outlined the performance differences between devices, due to differences in mechanical action, which are likely to result in different patient outcomes. The patient ‘friendly’ factors that were assessed to evaluate usability of each device were:

A. Orientation independent use, B. Ability to change exhalation resistance, C. Ease of cleaning, D. Ease of disinfecting, E. Life span of device, and F. Ability to use connected to a nebulizer.

For each factor, a score of either 1, 3 or 5 (the higher the better) was assigned, enabling a total score to be calculated. The scoring justification is supported from device leaflet content and previous publications.

See the results below:

The many differences in device ease of use and flexibility that are shown in the table will hopefully provide some guidance when selecting the best device for each patient.

Combining usability findings with evidence of likely efficacy when adherent will enable a more objective selection of device. Notwithstanding that the patient themselves will provide good validation of the correct choice.