Comparative Study of Different Inhaler Devices in Asthmatic Children

Abstract

Background:The inhaler is an important drug delivery system in the treatment of asthma, but inhaler technique is often inadequate. We assessed technique in children diagnosed with asthma, comparing the performance of three devices. Patients and Methods:In a cross-sectional survey, 523 children (271 boys, 252 girls, ages 5 to 12 years; mean±SD 7.53±1.79 years) demonstrated inhalation technique according to Netherlands Asthma Foundation criteria during a first visit to a primary care clinic in Abha, Saudi Arabia. Patients used the device with which they were most familiar (either pMDI, Turbuhaler or Diskus). Results: Two hundred children (38% of total population) used a pMDI, while 323 (62% of total population) used one of the dry powder inhalers‹173 (58%) the Turbuhaler and 150 (47%) the Diskus. Only 49 children (25% of the total population) completed the assessment without making a mistake. The remaining 474 (75% of the total population) performed one or more manuevers poorly. Only 80 children who used an MDI (40% of those using the device) completed 50% or more of the maneuvers correctly compared with 111 (69% of those using the device) and 100 (67% of those using the device) of those using the Turbuhaler and Diskus, respectively (P=0.001 for comparison of MDI with dry powder inhalers). Children whose mothers had intermediate school or higher education performed better than those whose mothers had less education (P=0.001). The father's education had no bearing on performance with the inhaler. Conclusion:The inhaler technique of most asthmatic children is poor, but technique is better in children who use a dry powder compared a metered-dose inhaler. The level of the mother's education is positively associated with better inhalation technique in the child. Ann Saudi Med 23 (6): [349][350][351][352][353]

Inhalation Devices in Asthma

“…17 The findings are similar to previous studies of poor technique, as only 25% of the study population completed the assessment successfully. His findings confirm the need for proper asthma educational programs across the country for both patients and medical staff.…”

The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children

“…Factors leading to nonadherence may be related to poor inhaler technique, a regimen with multiple drugs, concern regarding side effects from the drugs, or the cost of medications. [ 90 91 92 ] Other factors include lack of knowledge about asthma, lack of partnership in its management, inappropriate expectations, underestimation of asthma symptoms, use of unconventional therapy, and cultural issues. [ 93 94 ]…”

The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children

“…Factors leading to nonadherence may be related to poor inhaler technique, a regimen with multiple drugs or devices, concern regarding side effects from the drugs, or the cost of medications. [787980] Other factors include lack of knowledge about asthma, lack of partnership in its management, inappropriate expectations, underestimation of asthma symptoms, use of unconventional therapy, and cultural issues. [8182]…”