Repeated Demonstration on Inhaler Technique Impact: A Prospective Interventional Study

Abstract

INTRODUCTION: Asthma continues to be the most frequent chronic condition in the pediatric population. Its control is affected by the misuse of inhaled medication. Inhaler technique demonstration to patients or caregivers seems to reduce error rate. This prospective interventional study was designed to prove that repeated demonstration of the inhaler technique to patients and caregivers improves patients` compliance and reduces error rate.
METHODS: One hundred patients were asked to demonstrate inhaler technique in sequential visits (51 patients demonstrated three times and 19 twice), filling a form by the responsible doctor, with “yes” or “no” registry according to several varies related to inhaler technique, mouth wash and spacer care.
RESULTS: Thirty patients were excluded from final analysis because they had only one observation. Mean age of 2.8 years (±1.9 years), 63% boys. During the study, 43 patients reduced error rate, 11 maintained the error and 16 had a correct technique since the beginning. Over successive assessments, the number of errors decreased substantially in inhaler technique (p-value 0.019), mouthwash (p-value 0.000) and spacer care (p-value 0.038). The only factors that reduced error rate were previous technique demonstration (p-value 0.003) and preceding inhaler-user (p-value 0.038).
CONCLUSION: Correct inhaler technique demonstration has immediate positive impact on error reduction, which is amplified when successive demonstrations are performed by physicians.