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Published on: December 17, 2017
Asthmatic children and MDI verbal inhalation technique counseling
Marwa O Elgendy1, Amira H Hassan2, Haitham Saeed3
1Department of Clinical pharmacy, Teaching Hospital of Faculty of Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt; Department of Clinical pharmacy, Faculty of Pharmacy, Nahda university, Egypt.
Insights
Verbal counseling for metered-dose inhaler (MDI) use significantly improved asthma control in children. Regular checks of MDI technique and pulmonary function are crucial for effective asthma management in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pharmacy
Background:
- Metered-dose inhalers (MDIs) are common asthma medications, but correct technique is vital for efficacy.
- Improper MDI use can lead to poor symptom control and increased healthcare utilization in children with asthma.
- Verbal counseling is a potential strategy to improve MDI technique and outcomes.
Purpose of the Study:
- To evaluate the impact of verbal counseling on the MDI inhalation technique of pediatric asthma patients.
- To assess the effect of improved MDI technique on pulmonary function tests in asthmatic children.
- To determine the optimal frequency and duration of MDI counseling for children.
Main Methods:
- A prospective study involving pediatric asthma patients under 18 years old was conducted over two years.
- MDI inhalation technique was assessed, and errors were corrected during three monthly visits.
- Pulmonary function was evaluated using peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) at each visit.
Main Results:
- Eighty-one children with asthma participated, with a mean age of 14.4 years.
- The mean number of correctly performed MDI steps significantly increased with each subsequent visit (p < 0.05).
- Pulmonary function test scores showed a significant improvement by the third visit (p < 0.05).
- "Seal lips" and "slow inhalation" were identified as the most challenging steps for children.
Conclusions:
- Repeated verbal counseling and technique checks for MDIs are essential for pediatric asthma patients.
- Improving MDI technique through consistent counseling can lead to better pulmonary function in children.
- Verbal counseling serves as a valuable tool for enhancing MDI adherence and asthma management outcomes.
Objectives:
The present work aimed to study the role of metered-dose inhalers (MDI) verbal counseling on asthmatic children patients inhalation technique and their pulmonary functions.
Methods:
In this study many children younger than 18 years old with asthma were collected from University hospital outpatient clinics throughout two years period Their MDI inhalation technique was checked and the number of MDI inhalation technique mistakes were detected and corrected at the first visit and every month for two more visits (three visits). Their peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) as a percentage of the forced vital capacity (FVC) were checked at every visit.
Results:
81 asthmatic subjects (54 female) younger than 18 years old were collected with a mean (SD) age 14.4 (1.8) years old. Most of the patients' owned MDI contained salbutamol, however, some patients were using Beclometasone MDI or Beclometasone and salbutamol combination MDI. The mean number of correct steps performed was significantly increased (p < 0.05) as the number of visits increased. "Place the MDI mouthpiece between the teeth and seal with lips" and "To maintain slow inhalation rate until lungs are full" were the least steps correctly performed by the asthmatics children studied. There was a significant increase (p < 0.05) in the pulmonary function test scores at the third visit.
Conclusions:
MDI's verbal counseling should be repeated and checked at every opportunity, especially with children, to improve and maintain the recommended MDI inhalation technique. That could be a tool to possibly improve patients' pulmonary functions.
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