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Determinants of correct inhalation technique in children attending a hospital-based asthma clinic
A W A Kamps1, P L P Brand, R J Roorda
1Department of Pediatrics, Division of Pediatric Pulmonology, Isala Klinieken/Weezenlanden Hospital, Zwolle, The Netherlands.
Insights
Repeated inhalation instruction and patient demonstration improve correct inhaler technique in children with asthma. This ensures better medication delivery and asthma management for pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Management
Background:
- Incorrect inhaler device use is common in children with asthma, even after initial instruction.
- Effective inhalation technique is crucial for optimal asthma control and medication delivery.
Purpose of the Study:
- To identify factors associated with correct inhalation technique in pediatric asthma patients.
- To evaluate the impact of repeated instruction and patient demonstration on inhaler technique.
Main Methods:
- Two hundred children with asthma demonstrated their inhaler technique.
- Patient characteristics and instruction components were compared between correct and incorrect technique groups.
- Prospective follow-up of 47 newly referred patients after repeated instruction sessions.
Main Results:
- 78% of all patients initially demonstrated correct inhalation technique.
- Repeated instruction sessions and prior demonstration requests were significantly associated with correct technique (p < 0.001).
- Repetition of instructions (OR 8.2) and patient demonstration (for metered dose inhaler plus spacer, OR 3.5) were key factors. Newly referred patients improved from 57.4% to 97.9% correct technique after three sessions.
Conclusions:
- Repeated inhalation instruction is essential for achieving and maintaining correct inhaler technique in children with asthma.
- Incorporating patient demonstration into instruction sessions can enhance technique, particularly with metered dose inhaler plus spacer devices.
Unlabelled:
Many children with asthma use their inhaler device incorrectly even after comprehensive inhalation instruction. The aim of this study was to identify factors associated with correct inhalation technique. Two hundred children with asthma demonstrated their inhalation technique. Patient characteristics and the components of inhalation instructions they had received were compared for children demonstrating a correct or incorrect inhalation technique. In addition, the inhalation technique of 47 newly referred patients was followed-up prospectively after repeated comprehensive instruction sessions. Seventy-eight percent of all patients demonstrated a correct inhalation technique. Patients who had received repeated instruction sessions and patients who had previously been asked to demonstrate the use of their inhaler during an instruction session were more likely than other children to demonstrate a correct inhalation technique (p < 0.001 and p = 0.03, respectively). Multiple logistic regression analysis showed that repetition of instructions was significantly associated with a correct inhalation technique (odds ratio (OR) 8.2, 95% CI 3.2-21.5; p < 0.0001) irrespective of type of inhaler used. Demonstration of the inhaler use by the patient was significantly associated with a correct inhalation technique for patients using a metered dose inhaler plus spacer device (OR 3.5, 95% CI 1.0-12.6; p = 0.05). but not for patients using a dry powder inhaler (OR 1.6, 95% CI 0.4-6.4; p = 0.54). The number of newly referred patients demonstrating a correct inhalation technique improved from 57.4% to 97.9% after three comprehensive instruction sessions.
Conclusion:
Inhalation instruction should be given repeatedly to achieve and maintain correct inhalation technique in asthmatic children.