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Pediatrics |

Examining the Utility of Asthma Inhaler Education in Children With Asthma

Scott Bickel; Julie Burmester; Ronald Morton; Adrian O'Hagan; Nemr Eid
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University of Louisville, Louisville, KY


Chest. 2014;146(4_MeetingAbstracts):696A. doi:10.1378/chest.1990180
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Abstract

SESSION TITLE: Childhood Asthma Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Proper patient technique is crucial to optimal deposition of inhaled asthma medications. Multiple systems for delivering these medications exist such as a metered dose inhaler (MDI), dry power inhaler (DPI) or nebulizer. Improper technique can lead to poor disease control. This pilot study was designed to assess the impact of respiratory education on inhaler technique in infants and children with asthma.

METHODS: Patients, ages 6 months to 18 years, and their caregivers were recruited at an academic pediatric pulmonary clinic. Prior to respiratory education at that visit, proper device use by patient or caregiver was scored on standardized checklists to gage technique. If Patients were naïve to inhaled medications, new instructions were given. Families were then provided respiratory education on how to use their medication delivery device as well as a handout detailing each step. Patients were then reassessed by the same respiratory therapist at the next follow up visit. The paired student's t test was then used to assess for significant changes between scores at initial assessment and at follow up. Significance was set at p<0.05.

RESULTS: In this pilot study, 33 patients were enrolled and 21 had follow-up assessments. Twenty-five enrollees were male, 18 had Medicaid insurance, and the average age was 8.2 years. Twenty-eight patients used an MDI device. Five patients used a nebulizer while four patients used a DPI device. Seven patients reported using more than one device. One had no prior inhaler experience. Sixteen of the 28 patients using an MDI completed follow up assessments. Out of a ten point scaling system, the average initial MDI score indicated 6.4 steps were correctly performed. At follow up, the average number of steps correct improved to 9.4 (p = 0.0006).

CONCLUSIONS: This pilot study suggests that respiratory education in a pediatric pulmonary clinic combined with written instructions may be a valuable tool in increasing patient's ability to properly take their inhaled medication.

CLINICAL IMPLICATIONS: Respiratory education on inhaler technique is an important part of asthma care that can lead to improved ability to administer medications correctly.

DISCLOSURE: The following authors have nothing to disclose: Scott Bickel, Julie Burmester, Ronald Morton, Adrian O'Hagan, Nemr Eid

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