How we teach children with asthma to use their inhaler: a scoping review protocol

Abstract

Background: One reason that asthma remains poorly controlled in children is poor inhaler technique. Current guidelines recommend checking inhaler technique at each clinical visit. However, they do not specify how best to train children to mastery of correct inhaler technique. Currently, many children are simply shown how to use inhalers (brief intervention) which results in less than 50% with correct inhaler technique. The aim of this scoping review is to explore published literature on teaching methods used to train children to master correct inhaler technique. Methods: This scoping review will follow the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines. We will search (from inception onwards) MEDLINE, Embase, Scopus, Web of Science, CINAHL and the Cochrane library. We will include quantitative studies (e.g. randomised controlled trials, cohort studies and casecontrol studies), published from the year 1956 to present, on teaching the skill of inhaler technique to children with asthma. Two reviewers will complete all screening and data abstraction independently. Data will be extracted onto a data charting table to create a descriptive summary of the results. Data will then be synthesised with descriptive statistics and visual mapping. Discussion: This scoping review will provide a broad overview of currently used educational methods to improve inhaler technique in children with asthma. The analysis will allow us to refine future research in this area by focusing on the most effective methods and optimising them. Systematic review registration: Open Science Framework (osf.io/n7kcw).

Feasibility of video observed therapy to support controller inhaler use among children in West Baltimore

“…We also observed significantly improved inhaler technique and found a strong positive correlation between program engagement and mastery of inhaler technique. To date, heterogeneity has limited comparisons between studies and has impeded generating guidelines for best practices to improve asthma self-management among children (16,21,38). In general, comprehensive multi-component interventions are recommended (3) and have resulted in significant reductions in asthma-related emergency department visits, hospitalizations, and symptoms (39).…”

“…Moreover, brief interventions do not translate to sustained behavior change. Inhaler errors commonly persist after in-person or video instruction (14)(15)(16), and although various strategies appear to support inhaler adherence (e.g. education, reminders, feedback and incentives), no single strategy is effective across or within individuals over time (3).…”