Retention by Children of Device Technique for Inhaled Asthma Drugs Between Visits

Abstract

This study determined retention by children of drug delivery device technique between visits. Patients had asthma requiring the daily use of at least one medication delivery device. Seventy-two patients completed the study; 24 used only the metered dose inhaler (MDI) (group 1), while 48 used the MDI and 1 other device (group 2). Patients or caregivers were initially instructed on and demonstrated the correct use of their medication delivery device(s). At their next visit, they demonstrated their technique for each device. At follow-up, 36% correctly performed all components of the MDI. Group 1 (50%) was higher than group 2 (29%). The percent of correct MDI components for group 1 (84) was also higher than group 2 (78) but not significantly. For both groups and devices, breathing out before inhalation and breath holding was problematic. This study reinforces the need to demonstrate and observe the correct use of inhalation devices at each clinic visit.

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

“…34 Clearly, it is important to ascertain proper use of the inhalation technique at each clinic and with each visit. 35 Information concerning exposure to tobacco smoke was present in 14% of the medical records and advice to stop smoking was documented in only one case, even though this action has one of the highest priorities in healthcare. 5,6 Exposure to tobacco is one of the major causes of deterioration in children with asthma.…”

Utilizing a Physician Notification System in the EPIC Electronic Medical Record to Improve Pediatric Asthma Control: A Quality Improvement Project

“…7 Furthermore, skills in inhaler use tend to fatigue over time without reinforcement. 8 It is for these reasons that the NHLBI Guidelines also recommend teaching and reinforcing inhaler skills and adherence at every visit. This can be a time-consuming activity in a busy clinic, but assuring proper inhaler technique can be just as important as the type of inhaler being prescribed.…”

Imperative Instruction for Pressurized Metered-Dose Inhalers: Provider Perspectives

“…Although motor skills can be mastered effectively during brief sessions spaced over days, 19,20 ongoing skill use and training are needed to maintain proficiency over time. 6,7 Therefore, pMDI use could be most efficiently learned through brief but consistent practice in the days after initial instruction until the skill is mastered, coupled with reassessment and retraining to assure that the skill is retained. An up-front investment in the time and resources for this strategy could have longterm implications for improved asthma management.…”

“…A variety of educational techniques have been shown to improve inhaler technique in the short term. 6 However, skills in inhaler use deteriorate over time, 6,7 which indicates that a single instruction session may not be sufficient for patients to maintain proper technique. Previous studies have shown that repeating instruction sessions, demonstrating inhaler technique to patients, and having patients return the demonstration were all associated with higher rates of proper technique at follow-up visits.…”