Drug delivery and adherence in young children

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Shaikh Iqbal1, Sue Ritson, Ivan Prince

  • 1Department of Respiratory Medicine, Sheffield Children's Hospital, Sheffield, UK.

Pediatric Pulmonology
|March 17, 2004
PubMed

Insights

The HaloLite Paediatric Nebulizer (HPN) offers reproducible budesonide delivery in young children, though drug delivery was more variable with the pressurized metered dose inhaler and valved holding chamber (pMDI VHC). Parents preferred the pMDI VHC despite its variability.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Device Technology
  • Pharmacokinetics and Drug Delivery

Background:

  • Asthma management in young children (11-36 months) requires effective inhaled corticosteroid delivery.
  • Accurate dosing and adherence are critical for treatment efficacy in pediatric asthma.
  • Novel drug delivery systems aim to improve medication administration in infants and toddlers.

Purpose of the Study:

  • To compare the HaloLite Paediatric Nebulizer (HPN) with a pressurized metered dose inhaler and valved holding chamber (pMDI VHC) in pediatric asthma patients.
  • To evaluate drug delivery, treatment adherence, device compliance, and patient acceptability of two inhaler systems.
  • To assess the performance of a new nebulizer technology (HPN) against a standard pMDI VHC in a young pediatric population.

Main Methods:

  • A randomized, crossover pilot study involving 14 children (11-36 months) with asthma on inhaled corticosteroids.
  • Children used budesonide via HPN and pMDI VHC for 2-week periods each, with both devices featuring dataloggers.
  • Drug delivery, adherence, compliance, and acceptability were measured using device data and parental feedback.

Main Results:

  • Median delivered budesonide dose was 36 µg (CV 15%) for HPN vs. 53 µg (CV 47%) for pMDI VHC.
  • Median adherence was similar (68% HPN vs. 71% pMDI VHC), but true adherence was lower (23% HPN vs. 36% pMDI VHC).
  • Parents found the HPN less acceptable in terms of shape, size, and weight compared to the pMDI VHC.

Conclusions:

  • The HaloLite Paediatric Nebulizer (HPN) demonstrates reproducible budesonide delivery in very young children, utilizing advanced aerosol delivery technology.
  • While drug delivery with the pMDI VHC was more variable, parents expressed a preference for this device.
  • Further research is needed to optimize pediatric inhaler design for improved acceptability and consistent drug delivery.

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