Salmeterol Administration by Metered-Dose Inhaler Alone vs Metered-Dose Inhaler Plus Valved Holding Chamber

Demirkan, Kutay; Tolley, Elizabeth A.; Mastin, Terrye; Soberman, Judith E.; Burbeck, Joy; Self, Timothy H.

doi:10.1378/chest.117.5.1314

Cited by 19 publications

(13 citation statements)

References 31 publications

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“…Patients with asthma who continue to have the problem of co-ordinating the MDI activation with inhalation, even after repeated technique training sessions, are commonly prescribed a spacer device to use with their pressurised inhalers [12]. This has been instituted in the Asthma Management Guidelines as a recommended practice in young children aged less than 12 years where the issue of poor pMDI technique is more evident [17], [18].…”

Section: Discussionmentioning

confidence: 99%

“…Valved holding chamber (VHC) devices, commonly referred to as spacers, are used with pMDIs to overcome the common problem of hand-lung coordination associated with the pMDI use [11], [12]. When compared to the improper use of a pMDI alone, inhalation of the dose through a pMDI connected to a spacer device significantly improved the aerosol lung deposition [1], [13], [14], and reduced both the oropharyngeal [15] and systemic [16] inhaled corticosteroid-related adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of asthma control, parents’ quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma

Ammari

Toor²,

Chetcuti

et al. 2014

Journal of Asthma

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Objective: The AeroChamber Plus (AC) valved holding chamber has been enhanced to include the Flow-Vu (FV) inspiratory flow indicator that provides visual inhalation feedback during use. We have investigated if FV alters asthma control and whether parents accept it.Methods: At visit 1 children with asthma, age 1-5 years, used an AC with their pressurised metered dose inhaler and 2 weeks later (visit 2) they were randomised to use either AC or FV. Subjects returned 6 (visit 3) and 12 (visit 4) weeks later. The Asthma Control (ACQ) and Paediatric Asthma Caregiver's Quality of Life (PACQLQ) questionnaires were scored at each visit and their peak inhalation flow (PIF) when they used their spacer was measured.Results: Forty participants in each group completed the study. There was no difference in the ACQ scores from visits 2 to 4 between the 2 groups, whilst the improvements in the PACQLQ scores were greater in the FV group (p=0.029). The mean difference (95% confidence interval) for the change from visits 2 to 4 between FV and AC groups was 0.05 (-0.33, 0.43) and 0.39 (0.035, 0.737) for the ACQ and PACQLQ, respectively. Most parents preferred the FV (p<0.001). There was no difference in the PIF rates at each visit and between the two spacers. Conclusions:There was no change in asthma control of the young children but that of their parents improved. Parents preferred the FV and this could be related to their improved perception of their children's asthma control by better PACQLQ scores.Parent preference for spacer with visual feedback

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of asthma control, parents’ quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma

Ammari

Toor²,

Chetcuti

et al. 2014

Journal of Asthma

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“…Some patients, however, do not care to use them due to their size, as well as to the need for cleaning and maintenance. (7)(8)(9) Treatment failure in individuals with asthma frequently results from the incorrect use of metereddose inhalers, which is typically a consequence of a lack of counseling by health professionals, many J Bras Pneumol. 2008;34(1): [4][5][6][7][8][9][10][11][12] listed in Chart 1.…”

Section: Introductionmentioning

confidence: 99%

Avaliação do conhecimento sobre o uso de inaladores dosimetrados entre profissionais de saúde de um hospital pediátrico

et al. 2008

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Objective: To evaluate health professionals working at a tertiary pediatric hospital in terms of their knowledge regarding the practical use of metered-dose inhalers. Methods: Practical and written tests on the use of metered-dose inhalers were applied to physicians, physical therapists, nurses and nursing assistants. A score from 0 to 10 was assigned to each evaluation, and median scores were calculated for each professional category. Questions with higher and lower correct values were identified, and a descriptive comparison was made regarding the performance of the various professional categories. Statistical analysis was performed using the Kruskal-Wallis method for comparison of medians. A sequential logistic multiple regression analysis was also performed. Results: A total of 30 resident physicians or interns in the pediatrics department, 23 attending physicians, 29 physical therapists, 33 nurses and 31 nursing assistants were evaluated. Resident physicians, physical therapists and attending physicians performed significantly better than did nurses and nursing assistants. Only resident physicians had a median score greater than 6. Conclusions: The health professionals evaluated, particularly the nurses and nursing assistants, who are directly involved in the practical use of metered-dose inhalers, possess insufficient knowledge regarding the use of such inhalers.

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“…However, the operator requirements of hand-mouth coordination and the large amount of oropharyngeal drug deposition remain problematic, especially in children, who are less technically proficient than adults. 6 The use of a properly chosen holding chamber may enhance the delivery and distribution of the inhaled medications. The asthma expert panel established by the National Institutes of Health and the Cochrane Database of Systematic Reviews both recognize that the administration of a ␤-agonist by metered-dose inhaler and spacer is as effective as the gold standard of wet nebulization.…”

Section: Discussionmentioning

confidence: 99%

Hold it! Correct use of inhalers in children with asthma

Abrolat

Nguyen²,

Saca³

2001

Western Journal of Medicine

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Salmeterol Administration by Metered-Dose Inhaler Alone vs Metered-Dose Inhaler Plus Valved Holding Chamber

Cited by 19 publications

References 31 publications

Evaluation of asthma control, parents’ quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma

Evaluation of asthma control, parents’ quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma

Avaliação do conhecimento sobre o uso de inaladores dosimetrados entre profissionais de saúde de um hospital pediátrico

Hold it! Correct use of inhalers in children with asthma

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