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Ability of preschool children to use dry powder inhalers as evaluated by In-Check Meter
Yoko S Adachi1, Yuichi Adachi, Toshiko Itazawa
1Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan.
Insights
Preschool children aged 5 and 6 years can effectively use dry powder inhalers (DPIs), demonstrating adequate peak inspiratory flow rates (PIFR). The In-Check Meter is a useful tool for assessing this ability in young children with asthma.
Area of Science:
- Pediatric Respiratory Medicine
- Asthma Management
- Inhaler Device Technology
Background:
- Current asthma guidelines recommend metered-dose inhalers with spacers for preschool children.
- Dry powder inhalers (DPIs) present a potential alternative treatment option for this age group.
Purpose of the Study:
- To evaluate the capability of preschool children to inhale effectively using DPIs.
- To assess the peak inspiratory flow rates (PIFR) generated by children using DPIs.
Main Methods:
- 57 healthy children aged 3-6 years participated in the study.
- Peak inspiratory flow rates (PIFR) were measured using the In-Check Meter with resistances mimicking Diskus and Turbuhaler DPIs.
- Children practiced inhaler technique with an instructor prior to measurement.
Main Results:
- Inhaler ability improved with age; 30% of 3-year-olds and 79% of 4-year-olds could inhale reliably.
- 100% of children aged 5 and 6 years demonstrated reliable inhalation.
- Adequate PIFR for Diskus was achieved by 93.3-100% of children aged 4-6 years, while 62.5-91.7% achieved adequate PIFR for Turbuhaler.
Conclusions:
- The In-Check Meter effectively assesses preschool children's ability to generate adequate PIFR for DPIs.
- Children aged 5 years and older are generally capable of using DPI devices effectively.
- DPIs may be a viable alternative for asthma management in older preschool children.
Background:
Although current guidelines recommend the pressurized metered-dose inhaler with a spacer for preschool children with asthma, dry powder inhalers (DPI) may be a valuable treatment alternative.
Methods:
To evaluate the ability of preschool children to inhale through DPI, peak inspiratory flow rates (PIFR) of 57 healthy children aged 3-6 years were measured with In-Check Meter after practising with an instructor. Two different calibrated resistances were attached to the Meter to mimic the internal resistance of each inhaler; Diskus and Turbuhaler.
Results:
The ability of children to generate adequate inspiratory flow increased with age. The percentages of the 3-, 4-, 5-, and 6-year-old children who were able to inhale reliably through the devices were 30% (3/10), 79.0% (15/19), 100% (16/16), and 100% (12/12), respectively. In these children, 100%, 93.3%, 100%, and 100% achieved an adequate PIFR for the Diskus (30 L/min). In contrast, 66.7%, 66.7%, 62.5%, and 91.7% generated an adequate PIFR for the Turbuhaler (60 L/min).
Conclusions:
The In-Check Meter is a useful device to assess the ability of preschool children to generate adequate PIFR for each inhaler. Most children aged > or =5 years could use DPI.
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