Critical Errors in Inhaler Technique Common in Children With Asthma

Nearly half of children hospitalised for asthma demonstrate improper inhaler use, according to a study published in The Journal of Hospital Medicine.

“We know that asthma can be well-managed in the majority of patients and using your inhaler correctly is key factor to managing asthma,” said Waheeda Samady, MD, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois. “Improper inhaler technique can contribute to children having uncontrolled asthma. Our study suggests that as healthcare providers we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it.”

For the study, Dr. Samady and colleagues analysed the inhaler techniques of 113 children aged 2 to 16 years who were admitted to the hospital for an asthma exacerbation.

The researchers found that 55% of the children had uncontrolled asthma and 42% missed ≥1 critical step in their inhaler technique.

More patients missed a critical step when they used a spacer with mouthpiece instead of a spacer with mask (75% vs 36%) and were older (7.8 years vs 5.8 years).

Patients using the spacer with mouthpiece remained significantly more likely to miss a critical step when adjusting for other clinical covariates (odds ratio = 6.95; P = .007).

“We see that our adolescent patients, who are transitioning to independent medication management, still need close monitoring to make sure they use their inhaler and spacer appropriately to achieve optimal asthma control,” said Dr. Samady. “Teens may feel that using a spacer is only for younger children, but using a spacer is recommended for adults as well.”

Previous studies have shown that adding a spacer device to an inhaler increases the amount of asthma medication a person takes in from 34% to 83%.

“Children with asthma can lead full lives if they receive the right medication at the appropriate dose, which is why correct inhaler technique is so crucial,” concluded Dr. Samady.

Reference: http://doi.org/10.12788/jhm.3195

SOURCE: Ann & Robert H. Lurie Children’s Hospital of Chicago
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