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Effect of the whistle watch device on bronchodilator use in children with asthma
K Savva1, E U Rosen, K D Bolton
1Department of Paediatrics and Child Health, Coronation Hospital and University of the Witwatersrand, Johannesburg.
Insights
The whistle watch (WW) significantly reduced home bronchodilator use in children with asthma. This simple device offers an effective way to manage asthma symptoms and decrease medication reliance.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Medical Device Technology
Background:
- Asthma management in children often relies on subjective symptom assessment.
- Objective monitoring of asthma control can lead to more efficient treatment.
- Bronchodilator overuse can be a marker of poorly controlled asthma.
Purpose of the Study:
- To evaluate the impact of the whistle watch (WW) on home bronchodilator usage in pediatric asthma patients.
- To determine if objective peak flow monitoring influences medication adherence and need.
Main Methods:
- A prospective, randomized, crossover study design was employed.
- Children aged 6-18 with moderate-to-severe asthma were enrolled.
- Patients used either the WW for peak flow monitoring or relied on perceived symptoms to guide bronchodilator use, switching methods after 30 days.
Main Results:
- A significant reduction in mean monthly bronchodilator doses was observed with WW use (5.5 doses vs. 16.81 doses, p < 0.001).
- Individual patient data showed a wide range of bronchodilator dose reduction, from 13 extra to 71 fewer doses per month.
- Forty-three patients completed the study, with no significant demographic differences between completers and non-completers.
Conclusions:
- The whistle watch (WW) is a cost-effective and user-friendly tool for managing pediatric asthma at home.
- Objective peak flow monitoring with the WW effectively reduces the number of bronchodilator doses required by children with asthma.
- The WW device aids in optimizing asthma treatment by providing objective data for medication management.
Objective:
To determine if the use of the whistle watch (WW), a simple device to monitor peak flow rate, affects the use of bronchodilators at home.
Study Design:
Prospective, randomised, crossover design.
Setting:
The asthma outpatients' clinic at Coronation Hospital, a tertiary care centre in Johannesburg.
Patients And Methods:
Children between 6 and 18 years of age with moderate or severe asthma for more than a year were enrolled. They were randomised into two groups, with bronchodilator use determined either by the WW or solely by the patient's perceived symptomatology. The patients acted as their own controls, switching over to the other group after 30 days. Eighty patients were enrolled into the study.
Results:
Forty-three patients completed the study (54%). There were no significant differences between these patients and those who did not complete the study in terms of sex, age and treatment characteristics. There was a significant reduction in the mean monthly number of bronchodilator doses used by the WW group (5.5 doses v. 16.81 doses, paired t-test, t = 3.64, P < 0.001, 95% confidence interval (CI) 6.1-16.55). The change in individual participants varied between 13 extra bronchodilator doses and 71 fewer doses per month with the use of the WW device.
Conclusion:
The WW device is a cheap, easy-to-use and effective tool that reduces the number of bronchodilator doses used by asthmatic children at home.