No CrossRef data available.
Article contents
Appropriate inhaler formulations following tracheostomy or laryngectomy in patients with respiratory co-morbidities: a cohort study
Published online by Cambridge University Press: 04 November 2025
Abstract
Background
Currently, there is no guideline to support the conversion of inhaled medications to formulations suitable for patients undergoing tracheostomy or laryngectomy. This study aimed to evaluate prescribing practices and post-operative respiratory complications.
Methods
The first cycle of this cohort study (1 October 2018 to 28 February 2022) examined existing practice, while the second cycle (1 August 2023 to 31 July 2024) assessed the impact of a newly introduced prescribing tool. The primary outcomes were the proportion of patients prescribed appropriate inhaler formulation and the incidence of post-operative respiratory complications, stratified by formulation appropriateness.
Results
Our study demonstrated the tool improved appropriate formulation prescribing from 45 per cent to 60 per cent. In both cycles, patients receiving appropriate formulations had fewer post-operative respiratory complications.
Conclusion
A prescribing tool to facilitate formulation conversion was associated with improved prescribing practices and reduced complications, supporting the need for structured guidance in this high-risk population.
Keywords
Information
- Type
- Main Article
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.
Footnotes
Ping Hei Alfie Lee takes responsibility for the integrity of the content of the paper.
Presented at the British Association of Head & Neck Oncologists (BAHNO) 2025 Annual Scientific Meeting, 16 May 2025, London.
References
Landis, SH, El-Hariry, IA, van Herk-Sukel, MPP, van den Haak, P, Janssen-Heijnen, MLG, Penning-van Beest, FJA, et al. Prevalence and incidence of acute and chronic comorbidity in patients with squamous cell carcinoma of the head and neck. Head Neck 2012;34:238–44Google Scholar
Ari, A, Fink, JB. Inhalation therapy in patients with tracheostomy: a guide to clinicians. Expert Rev Respir Med 2017;11:201–8Google Scholar
van den Besselaar, BN, Sewnaik, A, Hoesseini, A, Dorr, MC, Baatenburg de Jong, RJ, Offerman, MPJ. Causes and ways of death in patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg 2024;150:303–10Google Scholar
Chronic Obstructive Pulmonary Disease in over 16s: diagnosis and management [NG115]. In: https://www.nice.org.uk/guidance/ng115 [1 February 2023]Google Scholar
Respiratory system, inhaled drug delivery. In: https://bnf.nice.org.uk/treatment-summaries/respiratory-system-inhaled-drug-delivery/ [1 February 2023]Google Scholar
Koroma, P, Moors, T, Saiyed, L, Mehdi, S. Dry powder inhaler alternatives for COPD patients post total laryngectomy. J Laryngol Otol 2025:1–3Google Scholar
BTS Position Statement Sustainability and the Environment: Climate Change and Lung Health 2024. In: https://www.brit-thoracic.org.uk/document-library/governance-and-policy-documents/position-statements/position-statement-on-sustainability-and-the-environment-climate-change-lung-health-2024/ [1 May 2023]Google Scholar
Maeda, K, Yamaguchi, M, Nagase, H, Yasuno, N, Itagaki, F, Watanabe, M. Utility and effectiveness of Symbicort Turbuhaler (oral inhalation containing budesonide and formoterol) in a patient with severe asthma after permanent tracheostomy. J Pharm Health Care Sci 2018;4:24Google Scholar
Johnson, DC. Interfaces to connect the HandiHaler and aerolizer powder inhalers to a tracheostomy tube. Respir Care 2007;52:166–70Google Scholar
Nandapalan, V, Currey, M, Jones, TM. A modified spacer device for inhalational drug therapy for chronic bronchitis/asthma in laryngectomised patients. Clin Otolaryngol Allied Sci 2000;25:118–19Google Scholar
Mirza, S, Hopkinson, L, Malik, TH, Willatt, DJ. The use of inhalers in patients with tracheal stomas or tracheostomy tubes. J Laryngol Otol 1999;113:762–4Google Scholar