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Some Children With Asthma Miss Critical Step in Inhaler Use

WEDNESDAY, April 24, 2019 -- Many children with asthma, especially older children using a spacer with mouthpiece, miss a critical step in inhaler technique, according to a study published online April 8 in the Journal of Hospital Medicine.

Waheeda Samady, M.D., from the Ann and Robert H. Lurie Children's Hospital of Chicago, and colleagues conducted a prospective cross-sectional study in a tertiary children's hospital involving 113 children aged 2 to 16 years admitted for an asthma exacerbation. The authors assessed inhaler technique demonstrations, including adherence to critical steps such as removing the cap, attaching to a spacer, taking six breaths, and holding their breath for five seconds.

The researchers found that 55 percent of the children had uncontrolled asthma and 42 percent missed a critical step in inhaler technique. Missing a critical step occurred among more patients using a spacer with mouthpiece compared with a spacer with mask (75 versus 36 percent). Those children missing a critical step in inhaler technique were also older (7.8 versus 5.8 years). After adjustment for other clinical covariates, patients using the spacer with mouthpiece were significantly more likely to miss a critical step (odds ratio, 6.95).

"Improper inhaler technique can contribute to children having uncontrolled asthma and needing to come to the hospital for their asthma," Samady said in a statement. "Our study suggests that as health care providers we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it."

One author disclosed financial ties to the biopharmaceutical industry.

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Posted: April 2019

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