For many years my asthma was well controlled by a combination of Serevent Accuhaler 50mcg 1xbd and Flixotide Accuhaler, 100mcg 1xbd (low season) and 250mcg 1xbd (high season). I also had, but almost never required, a Ventolin Accuhaler 200mcg. Two devices meant that I could tune the inhaled corticosteriod (ICS) while maintaining the long acting beta-2 agonist (LABA).
I really liked the Accuhalers. The rounded design was comfortable in pockets, they were fully enclosed when not in use and had a counter so you knew exactly how many doses were left and were sure of a full dose each time.
Last year I was switched to Fostair 100/6mcg (MDI), 1xbd (low season) and 2xbd (high season), with an Aerochamber Plus. So far, it seems to offer a similar level of control. Apparently, it has a shorter shelf life and the pharmacist has to store them in a refrigerator!
My treatment is now the 1st choice for step 3 on Asthma Pathway June 2015 from Cambridgeshire and Peterborough Clinical Commissioning Group. Looking through this document the majority of medications are MDI with few DPI.
I'm a little out of touch but is there now a good reason to prefer MDIs over DPIs?
I know that there is a DPI version of Fostair 100/6mcg, the Fostair NEXThaler. By chance, I discovered that one of my friends worked on the team that developed this NEXThaler. However, according to this New Medicine Report it has been designated NOT RECOMMENDED.
I am curious as to the processes involved. Does my CCG restrict the choice of inhaler type?
I would much prefer a DPI. Are there any good reasons why an MDI + spacer is considered better than the current generation of DPIs such as Fostair NEXThaler or Relvar Ellipta (also NOT RECOMMENDED)?