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Adequate use of asthma inhalation medication in children: more involvement of the parents seems useful.

ABSTRACT: BACKGROUND: Asthma and other chronic airway diseases can be effectively treated by inhaler therapy. Inhaler therapy depends on appropriate use of the inhaler. This study evaluates the knowledge among Dutch children and their parents regarding asthma inhaler therapy and appropriateness of its use. FINDINGS: Five general practices selected all children aged 0 to 12 years on asthma inhalation medication. Children demonstrated inhaler use and were interviewed with their parents.46 subjects were enrolled; mean age 5.5 years (SD 3.4) years; 26 (57%) were boys. Of the children using one inhaler only, 70% used the inhaler as indicated and of those using more than one inhaler 46%. On average 2.6 mistakes were made during demonstration of the technique, and 2 mistakes were reported in the interview. In total, 87% of the parents decided when and how the inhaler had to be used. Spacer cleaning was performed correctly by 49%; 26% reported a correct way of assessing how many doses were remaining. CONCLUSION: Dutch children make essential mistakes related to inhaler use that are easy to avoid. We recommend a better explanation and demonstration of the technique, and recommend involvement of the parents during instruction.

SUBMITTER: Uijen JH

PROVIDER: S-EPMC2718905 | biostudies-other | 2009

REPOSITORIES: biostudies-other

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Adequate use of asthma inhalation medication in children: more involvement of the parents seems useful.

Uijen Johannes H J M JH van Uijthoven Yannick J W YJ van der Wouden Johannes C JC Bindels Patrick J E PJ

BMC research notes 20090713

<h4>Background</h4>Asthma and other chronic airway diseases can be effectively treated by inhaler therapy. Inhaler therapy depends on appropriate use of the inhaler. This study evaluates the knowledge among Dutch children and their parents regarding asthma inhaler therapy and appropriateness of its use.<h4>Findings</h4>Five general practices selected all children aged 0 to 12 years on asthma inhalation medication. Children demonstrated inhaler use and were interviewed with their parents.46 subje ...[more]

PMID: 19594921

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Project description:IntroductionPreterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood.MethodsWe conducted a register-based study of a national cohort of all infants born in Denmark in 1980-2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled ß-2 receptor agonist and different controller treatment over 2-year periods) available from 1995-2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System.ResultsWe included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18-31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0-11 years) and for our youngest generations (born after 1995).ConclusionThe strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.

Project description:BACKGROUND:The burden of asthma and COPD among patients is high and people affected are frequently hospitalized due to exacerbations. There are numerous reasons for the lack of disease control in asthma and COPD patients. It is associated with non-adherence to guidelines on the part of the health care provider and with poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patient. This study aims to present data on inhaler technique and its impact on quality of life (QoL) and symptom control in a typical population of patients with chronic lung disease from a randomized controlled trial on medication adherence. METHODS:For this cross-sectional analysis, 165 asthma and COPD patients were analyzed. Correct application of inhaler devices was tested using pre-defined checklists for each inhaler type. QoL and symptom control were investigated using COPD Assessment Test (CAT) and Asthma Control Test (ACT). Spirometry was used to measure forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). RESULTS:Overall, incorrect inhalation technique ranged from 0 to 53% depending on the type of inhaler. COPD patients with incorrect device application had a higher CAT sum score compared to those with a correct device application (P?=?.02). Moreover, COPD patients with incorrect device application were more likely to suffer from cough (P?=?.03) and were more breathless while walking uphill or a flight of stairs (P?=?.02). While there was no significance found in asthma patients, COPD patients who used their devices correctly had a significantly better mean FEV1% predicted at baseline compared to those who applied their devices incorrectly (P?=?.04). CONCLUSIONS:Correct inhalation of prescribed medication is associated with improved health status and lung function. These findings should encourage health professionals to provide instructions on correct inhalation technique and to regularly re-evaluate the patients' inhalation technique. TRIAL REGISTRATION:ClinicalTrials.gov: NCT0238672 , Registered 14 February 2014.

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Adequate use of asthma inhalation medication in children: more involvement of the parents seems useful.

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Adequate use of asthma inhalation medication in children: more involvement of the parents seems useful.

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