Health & Medicine - Posted by Patric Lane-UNC on Wednesday, March 30, 2011 13:34 - 1 Comment 
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(1 votes, average: 5.00 out of 5) Loading ...Asthma: Only 1 in 4 kids pass inhaler test
Asthma is the most common chronic condition among American children. Related health-care costs are estimated at more than $6 billion a year, and lost productivity costs associated with working parents caring for children who miss school are estimated at $1 billion a year. (Credit: iStockphoto)
UNC-CHAPEL HILL (US) — Most children and teens with asthma have trouble using inhalers correctly, making it difficult to manage symptoms, a new study shows.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
While children have more success with newer inhaler designs, at best only one child in four gets it completely right, according to the findings published in the journal Pediatrics.
The study led by Betsy Sleath, a professor at the University of North Carolina at Chapel Hill, included 296 patients aged 8 to 16 years old who used four different devices to manage their asthma. The devices were:
- metered-dose inhaler (commonly called a puffer);
- diskus, a dry-powder inhaler delivering Advair;
- turbuhaler, a dry-powder inhaler delivering Pulimcort or Symbicort; and
- peak-flow meter, which does not deliver a drug but is used to measure lung function to determine if medicine is needed.
Only 8.1 percent of children in the study performed all of the metered-dose inhaler steps correctly. Older children were more likely than younger children to get more of the metered-dose inhaler steps correct. With a diskus, 21.9 percent of children performed all steps correctly, and 15.6 percent performed all of the turbuhaler steps correctly. Children using a peak-flow meter did so correctly 23.9 percent of the time.
The researchers also found the majority of health-care providers who participated in the study (41 providers at five clinics) did not demonstrate or assess children’s use of the four devices during pediatric asthma visits.
“It is crucial that health-care providers not only show a child how to use an inhaler correctly but also have the child demonstrate the device in front of a physician or pharmacist,” says Sleath. “Pediatric practices are extremely busy places so we need innovative ways to demonstrate and assess device technique among asthmatic children.”
Improper use of inhalers and other asthma medication devices can lead to poor control of the condition, more hospitalizations, and increased health-care costs, she adds.
Previous studies have noted the need for providers to demonstrate and make sure children understand proper techniques for using asthma medication and monitoring devices. In 2007, a National Heart, Lung and Blood Institute expert panel report on the diagnosis and management of asthma encouraged providers to educate children on these techniques.
Researchers from San Diego State University and Husson University in Bangor, Maine, collaborated on the work, which was funded by the National Institutes of Health.
More news from UNC-Chapel Hill: http://uncnews.unc.edu/
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Asthma Inhalers’ Design Leaves a Lot To Be Desired
A recent article in Futurity quotes study findings that three out of four kids and teens with asthma have trouble using inhalers properly and only one in four gets it completely right.
The study’s leader, Betsy Sleath, included 296 patients aged eight to 16 using four different devices, three of which deliver medication, one of which is a need assessment device. The top scoring drug delivery device, Advair’s diskus, had the high score with just 21.9 percent of participants able to perform all steps correctly.
Sleath advises pediatric medical practices to not only show a child how to use a device, but also have the child demonstrate the device use in front of the doctor or pharmacist to enhance effective delivery and prevent hospitalizations that can result from poor control of the condition.
Who could argue with the need for that? No one. But one could certainly argue that such devices, even when placed in the hands of relatively young children, should be more intuitive, more user-friendly then they apparently are. Given the time that may elapse between that learning and demonstration session and the actual incident requiring the use of the device, it seems reasonable to presume that most kids (and many adults) will have forgotten some or maybe even all of the proper use protocols.
It is crucial then that in designing and engineering inhalers, turbuhalers and diskuses, medical device designers rely on sound human factors engineering and early and frequent usability testing. And it’s certainly easy to understand why the FDA enacted the new standard, HE-75, to point the way. With the new standard in place, human factors and usability are well integrated into the process required for regulatory approval helping to insure that companies put out products that reduce risk factors related to misuse. And that’s the good news.
Aidan Petrie,
CIO, Ximedica