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[Evaluation of inhalation treatment in asthmatic infants]
M Gracia Antequera1, M M Morales Suárez-Varela, R Taberner Pedrós
1Servicio de Pediatria, Hospital Dr. Peset Aleixandre, Valencia.
Insights
Asthmatic children often misuse inhalation devices, with higher error rates in younger patients. Expansion chambers show the highest correct usage rates across all age groups, indicating their potential for improved medication delivery.
Area of Science:
- Pediatric Respiratory Medicine
- Inhaler Device Technology
Background:
- Inhalation therapy is crucial for managing childhood asthma.
- Proper inhaler technique is essential for effective medication delivery and treatment outcomes.
- Various inhaler devices exist, each with unique handling requirements.
Purpose of the Study:
- To evaluate the efficacy and correct usage of different inhalation devices in asthmatic children.
- To identify factors influencing correct inhaler handling among pediatric patients.
Main Methods:
- A study involving 227 young asthma patients assessed their handling of three device types: direct pressurized aerosol, dry powder device, and pressurized aerosol with an expansion chamber.
- Observed handling involved five distinct steps.
- Data analysis included frequency distributions, confidence intervals, and logistic regression.
Main Results:
- Correct inhaler handling rates were 37.2% for dry powder devices, 51.2% for direct pressurized aerosols, and 58.6% for expansion chamber aerosols.
- Inhaler misuse increased with patient age for direct pressurized aerosol and dry powder devices.
- Parental instruction and treatment duration exceeding 22 months without reinforcement correlated with increased misusage.
Conclusions:
- A significant percentage of children incorrectly use direct pressurized aerosol and dry powder devices, with technique worsening with age.
- Expansion chamber aerosols demonstrated the highest correct usage rates and consistency across age groups.
- Intervention strategies should focus on improving device education, especially for younger children and long-term treatment durations.
Objective:
The aim of this study was to evaluate the efficacy of treatment of asthmatic children by inhalation.
Patients And Methods:
Two hundred twenty-seven young patients have taken part in a practical inquiry regarding the handling of their inhalation device and showing how they attained the appropriate dosage of medicine by using either the direct pressurized aerosol, the dry powder device or pressurized aerosol in an expansion chamber. Five different steps have been observed in the handling of the above mentioned devices. After assembling the data, a profile has been compiled (through absolute and relative frequencies and a 95% confidence interval) and a logistic regression multivariant analysis.
Results:
Correct handling was observed in 37.2% of the children who used the dry powder device, 51.2% in the children who used the direct pressurized aerosol and 58.6% of those who used the expansion chamber aerosol. The influence of the duration of the treatment plus the age of the patient was also taken into consideration.
Conclusions:
From this study it follows that the direct pressurized aerosol treatment and the dry powder device are incorrectly handled by a high percentage of children and this problem gets worse as the age of the patient increases. In contrast, the proportion of children who use correctly the expansion chamber aerosol is highest and remains similar for all age groups. Misusage increases when the explanation of the treatment is provided by the parents and also when the treatment occurs for a period greater than 22 months without reminding the patient of the correct usage of the apparatus.
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