[Compliance with inhalation therapy in children with respiratory diseases]

Air compressors for inhalation devices were equipped with counters which were activated whenever the inhalation was started. They recorded the time of the activated inhaler. The counters were invisible for the parent and the doctor. 40 outpatients, all children, were randomly given such a device for treatment at home under surveillance of their parents. The duration, dose and frequency of inhalation was explained, and the parents were instructed that if the child should not be well, the inhalation frequency could be doubled. 21 children (age: 3.8 +/- 3.7 years from two months to 14 years), five girls, 16 boys, were on the inhalation devices equipped with the counter; ten had asthma, four acute bronchitis, four mild bronchiolitis, one had pertussis, one cystic fibrosis and one pneumonia. The prescribed inhalation treatment extended over 21 +/- 14 days (3 to 50), the inhalation frequency per day was one to three times. The measured inhalation unit (recorded inhalation time times frequency) amounted to 4.87 +/- 5.01 vs. 4.31 +/- 3.58 (n.s.) for the expected unit (expected inhalation units according to the prescription). The maximum and the minimum differences for the measured vs. the expected unit were significantly different (p < 0.001). Ten children inhaled 80 to 120% of the prescribed inhalation units, six children inhaled more than 140%, and five children less than 70% of the prescribed units. This resulted in an overall inhalation compliance of 47.6%. This is the first double-blind study carried out so far studying inhalation compliance in children with respiratory diseases.