Choosing the metered-dose inhaler spacer or holding chamber that matches the patient's need: Evidence that the specific drug being delivered is an important consideration

Ahrens, Richard C.; Lux, Cheri; Bahl, Teri; Han, Seung-Ho

doi:10.1016/s0091-6749(95)70208-3

Cited by 70 publications

(27 citation statements)

References 9 publications

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“…32 The design used in the present study can be used by manufacturers in future studies of drugs and devices to identify combinations with similar systemic exposure. This information can then be used in designing long-term efficacy and safety studies in young children.…”

Section: Discussionmentioning

confidence: 99%

Lung bioavailability of hydrofluoroalkane fluticasone in young children when delivered by an antistatic chamber/mask

Khan

Tang

Hochhaus

et al. 2006

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Lung bioavailability of hydrofluoroalkane fluticasone in young children when delivered by an antistatic chamber/mask

Khan

Tang

Hochhaus

et al. 2006

The Journal of Pediatrics

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“…Spacer use is associated with better asthma outcomes, 12,45,46 and counseling about spacer use is considered the standard of care in asthma management. 1 Based on previously collected pilot data from our clinic, we estimated a baseline rate of provider inclusion of spacer use as part of action plan counseling as being ∼50%.…”

Section: Sample Size Estimationmentioning

confidence: 99%

A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study

et al. 2016

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BACKGROUND AND OBJECTIVES:The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram-and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan.

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“…While all VHCs decrease deposition of aerosolized drug in the oropharyngeal cavity, their effect on delivery to the lungs varies. 26 In patients who cannot coordinate the actuation and inhalation of MDIs, especially in young chil-dren, delivery is generally enhanced with a VHC. However, using a facemask in young children (necessary in children < 5 years old) decreases lung delivery by one-half compared to inhalation through a mouthpiece for both VHCs and nebulizers.…”

Section: Devicementioning

confidence: 99%

MDI versus Nebulizers for Acute Asthma

Raissy

Kelly

2004

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVE: To evaluate studies comparing metered dose inhalers with holding chambers to nebulizers in the emergency department for the treatment of asthma exacerbation. DATA SOURCE: Primary articles and systematic review provided by the Cochrane Airways Review Group of the Cochrane Library identified by MEDLINE search (1966–February 2004) and through secondary sources. DATA SYNTHESIS: The Cochrane review included 21 randomized clinical trials conducted in hospital emergency departments comparing clinical outcomes following β2 agonist administration via a nebulizer or a metered dose inhaler with holding chamber. Although the relative risk ratio of hospital admission with metered dose inhaler and holding chamber did not differ in children or in adults compared to the nebulizer delivery, none of the individual studies reviewed were powered to detect a difference in the rate of hospital admission. Specific factors in the treatment of acute asthma such as assessment of severity, appropriate outcome selection, appropriate dose selection, and appropriate delivery systems need to be considered to critically evaluate the literature. CONCLUSION: Although available randomized clinical trials suggest equivalency of metered dose inhaler plus holding chambers and nebulized delivery of inhaled β2 agonists, these trials are biased to show no difference in response. There is no data to support the advantage of one method over the other in mild to moderate asthmatic patients either clinically or economically.

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Choosing the metered-dose inhaler spacer or holding chamber that matches the patient's need: Evidence that the specific drug being delivered is an important consideration

Cited by 70 publications

References 9 publications

Lung bioavailability of hydrofluoroalkane fluticasone in young children when delivered by an antistatic chamber/mask

Lung bioavailability of hydrofluoroalkane fluticasone in young children when delivered by an antistatic chamber/mask

A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study

MDI versus Nebulizers for Acute Asthma

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