Study of inhaler technique in asthma patients: differences between pediatric and adult patients

Abstract

Objective: Inhaler technique comprises a set of procedures for drug delivery to the respiratory system. The oral inhalation of medications is the first-line treatment for lung diseases. Using the proper inhaler technique ensures sufficient drug deposition in the distal airways, optimizing therapeutic effects and reducing side effects. The purposes of this study were to assess inhaler technique in pediatric and adult patients with asthma; to determine the most common errors in each group of patients; and to compare the results between the two groups. Methods: This was a descriptive cross-sectional study. Using a ten-step protocol, we assessed inhaler technique in 135 pediatric asthma patients and 128 adult asthma patients. Results: The most common error among the pediatric patients was failing to execute a 10-s breath-hold after inhalation, whereas the most common error among the adult patients was failing to exhale fully before using the inhaler. Conclusions: Pediatric asthma patients appear to perform most of the inhaler technique steps correctly. However, the same does not seem to be true for adult patients.

Asma E a Técnica Inalatória Do Inalador Pressurizado Dosimetrado Acoplado Ao Espaçador: Revisão Integrativa

“…Quanto à justificativa dos passos da técnica inalatória usados pelos artigos, seis utilizaram apenas referências da literatura (11)(12)14,16,(18)(19) ; um estudo, além de usar a literatura, validou a sequência de passos com quatro peritos (13) ; três artigos indicaram a escolha da técnica baseados em revisão de literatura e instruções de fabricantes em bulas (15,20,22) ; um artigo referenciou, além da literatura e instruções de fabricantes, um guideline (17) ; um estudo indicou que a técnica foi desenvolvida a partir de literatura revisada e experiência clínica de especialistas (21) ; e dois artigos referenciaram um guideline (23)(24) .…”

“…Quanto à idade do grupo de aplicação da técnica, verificou-se que três estudos (11,20,24) trabalharam tanto com crianças quanto adultos, um estudo (16) indicou ter aplicado em indivíduos com idade igual ou superior a 14 anos, oito estudos (12)(13)(14)(15)(18)(19)(22)(23) aplicaram em adultos e dois (17,21) em crianças.…”

“…Para selecionar as publicações incluídas na pesquisa, adotou-se as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) (10) Manríquez P, Acuña AM, Muñoz L, et al (11) Estudo transversal Jornal Brasileiro de Pneumologia (2015)…”

Sixty Years After Inhalational Devices- Where Do We Stand?

“…7 Despite long time since development, more than 60 years, inhaler technique errors continue to be common among respiratory patients thus reducing the benefits of inhaled medications. 9 Problems with inhaler techniques were recognised shortly after the launch of pMDIs in the 1960s and reviews show that incorrect inhaler technique is unacceptably frequent and has not improved over the past 40 years. 10 Furthermore, incorrect technique has been reported in up to 94% of patients 4,8,[11][12][13] and poor technique was estimated to be prevalent in an average of 50% of cases.…”

“…18 Studies have shown that with incorrect technique drug delivery to the distal airways is affected, which prevents drug deposition on the respiratory epithelium. 6,9,19 Poor inhaler technique with inhaled corticosteroids and bronchodilators results in loss of their effect, increased reliever use and worsening asthma. 20, Patients are unable to use them properly due to the lack of knowledge and education on proper inhalational techniques.…”