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Assessment of inhalation technique in children with asthma, Abha, Saudi Arabia
1Pediatric Pulmonology Division, Department of Paediatrics, College of Medicine and Health Sciences, King Khalid University, Abha Assir central Hospital, Abha, K.S.A. Fariss2000@yahoo.com
Insights
Most children with asthma struggle with correct inhaler technique, leading to poor medication delivery. The Turbohaler showed the easiest technique, highlighting the need for patient and family education on proper inhaler use.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pharmacy
Background:
- Inhaler devices are crucial for delivering asthma medication to children.
- Correct inhalation technique is essential for effective drug delivery and asthma management.
- Poor technique can lead to suboptimal treatment outcomes and increased healthcare utilization.
Purpose of the Study:
- To assess the inhalation technique of pediatric asthma patients.
- To identify common errors in inhaler use among children.
- To compare the ease of use of different inhaler devices (MDI, DPI - Turbohaler, Diskhaler).
Main Methods:
- A standardized inhaler checklist from the Netherlands Asthma Foundation was used.
- 437 newly referred pediatric asthma patients (5-12 years) demonstrated their technique.
- Patients completed a questionnaire regarding prior inhalation instructions.
Main Results:
- Only 8.2% of patients used their inhalers correctly; 91.8% made at least one error.
- Correct technique rates varied by device: Turbohaler (12.2%), Diskhaler (8.9%), Metered-Dose Inhaler (MDI) (5.4%).
- Older children (8-12 years) demonstrated better technique than younger children (5-7 years) (p=0.001).
Conclusions:
- A significant majority of pediatric asthma patients exhibit poor inhaler technique, compromising drug delivery.
- The Turbohaler was associated with the easiest inhalation technique, followed by Diskhaler and MDI.
- Comprehensive education for children with asthma and their families is critical to improve inhaler technique and ensure effective treatment.
Unlabelled:
The inhalation technique of asthma in children was assessed using the criteria defined by the standardized inhaler checklist of the Netherlands Asthma Foundation and Dutch asthma foundation. Four hundred and thirty seven newly referred patients to chest clinic, department of pediatric, Assir Central Hospital, Southwestern Saudi Arabia were instructed to demonstrate their inhalation technique and to fill out a questionnaire related to the inhalation instructions received before their referral.
Results:
Four hundred and thirty seven patients newly referred for evaluation of their asthma (5-12 years of age with mean age of 7.16+1.69 years, 202 (46.2%) girls, 235 (53.8%) boys were included in the study. Two hundred two (46.2%) patients use MDI. The remaining (53.8%) patients use the DPI, 123 (52.35%) of them use turbohalers while 112 (47.65%) use diskhalers. Only 36 patients (8.2 %) completed the assessment without making any mistake. Of the remainders, 399 (91.8%) made one or more mistakes. Of the MDI users, eleven patients (5.4%) performed correctly all the steps, and 54 (26.7%) performed correctly four or more steps. Ten (8.9%) of the diskhaler users performed all the steps correctly and forty nine (43.8) performed correctly four or more steps. Fifteen (12 2%) of the turbohaler users performed correctly all the steps and ninety five (77.2%) performed correctly four or more steps. One hundred five of the male patients (44.7%), performed correctly more than three steps as compared to 93 of the female patients (46.5) with p value=0.704. One hundred and one patients (67.3%) between the age of 8-12 years performed more than three steps correctly as compared to 97 (33.8%) of patients aged 5-7 years (p=0.001).
Conclusion:
In conclusion, many asthmatic children use their inhaler devices too poorly with the result of an unreliable drug delivery. Turbohaler device inhalation technique was the easiest, followed by diskhaler then lastly the MDI. Education of asthmatic children and their families is highly needed to make sure the patient perform the correct inhalation technique.
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