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A systematic review of instruments aimed at evaluating metered-dose inhaler administration technique in children
Carlos E Rodríguez-Martínez1,2,3, Monica P Sossa-Briceño4, Gustavo Nino5
1a Department of Pediatrics , School of Medicine, Universidad Nacional de Colombia , Bogota , Colombia.
Insights
This study reviewed 24 tools for assessing pressurized metered-dose inhaler (pMDI) technique in children. Four instruments were identified as best, but further validation is needed for clinical use.
Area of Science:
- Pediatric Respiratory Medicine
- Pharmaceutical Technology
- Clinical Assessment Tools
Background:
- Accurate pressurized metered-dose inhaler (pMDI) technique is crucial for effective asthma and COPD management in children.
- Numerous instruments exist to evaluate pMDI administration, but their quality and suitability for pediatric populations vary.
- A systematic evaluation of these instruments' measurement properties is needed to guide clinical practice and research.
Purpose of the Study:
- To systematically review instruments designed to evaluate pMDI administration technique in children.
- To assess the measurement properties (reliability, validity, utility) of identified instruments.
Main Methods:
- Systematic literature search to identify instruments for evaluating pediatric pMDI technique.
- Evaluation of instruments based on predefined criteria including measurement properties, clarity, and usability.
- Comparative analysis of identified instruments.
Main Results:
- Twenty-four instruments were identified, assessing children aged 1 month to 18 years.
- Only 7 instruments reported measurement properties, primarily reliability and utility.
- Four instruments were identified as the most suitable based on available information and properties.
Conclusions:
- Four instruments are recommended for assessing pediatric pMDI technique, but require further validation.
- Additional research is necessary to confirm the measurement properties of these selected instruments before widespread clinical adoption.
- Improved assessment tools are needed to ensure optimal pMDI use in pediatric patients.
Objective:
The objective of the present study was to perform a systematic review of instruments aimed at evaluating pressurized metered-dose inhaler (pMDI) administration technique in children and evaluating the measurement properties of these instruments.
Methods:
A systematic search of the literature was performed in order to identify studies in which an instrument (scale, checklist, or questionnaire) for evaluating pMDI administration technique in children was described. Instruments were evaluated based on their reliability, validity, utility, endorsement frequency, restrictions in range, comprehension, lack of ambiguity, and lack of value-laden or offensive content.
Results:
A total of 24 instruments were identified. The age of the children ranged from 1 month to 18 years, the number of steps or items included in the instruments ranged from 3 to 21, and nearly half of the instruments distinguished between essential and non-essential steps or items. In only 7 of the 24 instruments was there a report of their measurement properties, mainly reliability and utility. Taking into consideration the information contained in the instruments, as well as their measurement properties, we determined four instruments to be the best of the available ones.
Conclusions:
Among the 24 instruments for the assessment of pMDI administration technique in children that were identified and systematically examined, four were considered to be the best ones available. However, additional evaluation of their measurement properties should be done before using them in clinical practice and for research purposes.
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