Child and parent satisfaction with the use of spacer devices in acute asthma

Cotterell, Elizabeth; Gazarian, Madlen; Rl, Henry; O’Meara, Matthew; Wales, Sandra

doi:10.1046/j.1440-1754.2002.00063.x

Cited by 27 publications

(19 citation statements)

References 17 publications

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“…It often requires a devoted champion willing to undertake this cause. 2,[15][16][17] The most important external factors influencing MDI+S implementation in the PED are the safety and feasibility of reusing spacers, cost to the PED, parental perceptions, and perceived increase in nursing workload.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, MDI+S have been shown to be preferred by both children and parents over nebulizers in the pediatric emergency department (PED) setting. 2 Despite this evidence, the majority of PEDs in Canada and the United States have not adopted MDI+S technology for acute asthma treatment. 3 The literature describes several possible barriers to implementing medical evidence in practice.…”

mentioning

confidence: 99%

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Barriers to Metered-dose Inhaler/spacer Use in Canadian Pediatric Emergency Departments: A National Survey

Osmond

Gazarian

Henry

et al. 2007

Academic Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Barriers to Metered-dose Inhaler/spacer Use in Canadian Pediatric Emergency Departments: A National Survey

Osmond

Gazarian

Henry

et al. 2007

Academic Emergency Medicine

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“…Furthermore, pediatric subjects and families who had previously used small-volume nebulizers to administer bronchodilators overwhelmingly preferred pMDIs/VHCs after using them for a short time. 58 There have been a few studies in non-intubated infants and children that have evaluated drug delivery via jet nebulizers and pMDIs/spacers. Unfortunately, these studies compared jet nebulizers and pMDI using spacers that were not valved or constructed using charge-dissipative materials.…”

Section: Jet Nebulizer Versus Pressurized Metered-dose Inhaler/spacermentioning

confidence: 99%

Clinical Controversies in Aerosol Therapy for Infants and Children

DiBlasi

2015

Respir Care

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Pediatric patients are different from adult patients with respect to airway anatomy and breathing patterns. They are also incapable of following commands and often reject breathing treatments. For these reasons, aerosol drug delivery is one of the most technically challenging aspects for clinicians providing respiratory care to young children. Improvements in nebulizer technology have provided better delivery options for pediatric patients. This review highlights research related to pediatric nebulizer and interface devices and how they can be used to provide the safest and most efficient treatments with the array of treatment delivery options. Also addressed are clinical controversies and debates in pediatric aerosol science, including drug delivery in crying versus resting infants, pressurized metered-dose inhalers and small-volume nebulizers for bronchodilator administration, continuous nebulization, noninvasive drug delivery options, and optimization of nebulizer performance during infant and large pediatric conventional and high-frequency ventilation.

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“…2 MDI-s also result in increased child and parent treatment satisfaction and may reduce staff and caregiver risk during respiratory infection epidemics. [3][4][5] Although PEDs in Canada are now accepting MDI-s as the route of choice for salbutamol inhalation, 6 one of the factors linked to resistance to switching salbutamol inhalation methods is the perception of increased costs. 7,8 The cost-effectiveness of MDI-s versus NEB has been documented, 4,[9][10][11][12] but no published Canadian study has used local clinical and administrative data in their analysis.…”

Section: Introductionmentioning

confidence: 99%

A Cost Analysis of Salbutamol Administration by Metered-Dose Inhalers with Spacers versus Nebulization for Patients with Wheeze in the Pediatric Emergency Department: Evidence from Observational Data in Nova Scotia

Spin¹,

Sketris²,

Hill-Taylor³

et al. 2016

CJEM

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Background: Despite evidence demonstrating the advantages of metered-dose inhalers with spacers (MDI-s), nebulization (NEB) remains the primary method of asthma treatment in some pediatric emergency departments (PEDs). There is a perception that delivering salbutamol by MDI-s is more costly than by NEB. This research evaluates the relative costs of MDI-s and NEB using local, hospital-specific, patientlevel data. Methods: Regression models estimated associations between the salbutamol inhalation method and costs, length of stay (LOS) in the PED and hospital, and the probability of admission. Our population was a random sample of 822 patients presenting with wheeze to the PED in 2008/2009. Control variables included age, sex, triage acuity, time of PED visit, other medications, and vitals. Costs were calculated using the prices and quantities of medical resources used per treatment. Probabilistic sensitivity analysis was used. Results: Treatment with MDI-s versus NEB was associated with an absolute decrease in hospitalization of 4.4% (p < 0.05) and a 25-hour (p < 0.001) reduction in average inpatient stay, after controlling for triage acuity and patient characteristics. This resulted in savings of $24/patient in the PED and $180/ patient overall (p < 0.001). Inpatient care accounted for more than 90% of total patient costs. Conclusions: Our results suggest economic gains associated with MDI-s for salbutamol inhalation in PEDs. Sensitivity analyses show that this conclusion is not affected by changes in model parameters that may differ by jurisdiction. Since most facilities already collect the data used for this study, our methods could be adopted for a cross-jurisdictional account of the cost effectiveness of MDI-s.

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Child and parent satisfaction with the use of spacer devices in acute asthma

Abstract: The use of spacer devices in mild to moderately severe acute asthma is highly acceptable for children and parents; the majority prefer this mode of drug delivery to nebulization.

Cited by 27 publications

References 17 publications

Barriers to Metered-dose Inhaler/spacer Use in Canadian Pediatric Emergency Departments: A National Survey

Barriers to Metered-dose Inhaler/spacer Use in Canadian Pediatric Emergency Departments: A National Survey

Clinical Controversies in Aerosol Therapy for Infants and Children

A Cost Analysis of Salbutamol Administration by Metered-Dose Inhalers with Spacers versus Nebulization for Patients with Wheeze in the Pediatric Emergency Department: Evidence from Observational Data in Nova Scotia

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