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.
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.
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