DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20203618

An evaluation of the technique of use of metered dose inhaler administration in bronchial asthma children

Mustak M. Makarani, Prakruti P. Patel, Anuradha M. Gandhi, Chetna K. Desai, Mira K. Desai

Abstract


Background: Inadequate understanding and performance of drug administration using metered-dose inhaler (MDI) in paediatric population affects therapeutic outcome. Hence, this study aimed to evaluate the impact of two educational interventional methods for usage of MDI in paediatric patients of bronchial asthma.

Methods: This prospective, interventional study was done in paediatric asthma patients who were prescribed drugs with (MDI) with/without spacer at outpatient department of pediatrics. Patients were divided in group A (video) or group B (leaflet) as per random table method and method to use MDI was assessed by using checklist as per WHO guide to good prescribing at baseline. Investigator taught the technique by a video (group A) and leaflet (group B) to the selected population. Patients were followed up after 15 days and assessed for use of MDI using the same checklist. Data were analysed by using paired and unpaired ‘t’-test.

Results: A total of 100 pediatric asthma patients were included in study group A (50) and group B (50). The average no. of steps (WHO checklist) followed was significantly improved at post intervention in both group A (with spacer, p<0.0001) as well as B (without spacer, p<0.05). Although average no. of steps followed were more in group A, no significant difference was found between two groups after intervention.

Conclusions: As video is an audio-visual method of demonstration, and hence help us memorise the step of inhalational technique in pediatric patients. Repeated demonstration/education to patients/caregivers may improve the method of MDI usage.


Keywords


Metered dose inhaler (MDI), Bronchial asthma, Pediatric patients

Full Text:

PDF

References


Chronic respiratory diseases. Available at: http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf. Accessed on 22 April 2014.

Reid J, Marciniuk DD, Cockcroft DW. Bronchial Asthma management in the emergency department. Can Respir J. 2000;7:255-60.

Gurkan F, Ece A, Haspolat K, Derman O, Bosnak M. Predictors for multiple hospital admissions in children with Bronchial Asthma. Can Respir J. 2000;7:163-6.

Majeed R, Rajar UD, Shaikh N, Majeed F, Arain AA. Risk factors associated with childhood asthma. J Coll Physicians Surg Pak. 2008;18(5):299-302.

Pal R, Dahal S, Pal S. Prevalence of Bronchial Asthma in Indian Children. Indian J Community Med. 2009;34(4):1.

Wilson SR, Scamagas P, German DF. A controlled trial of two forms of self-management education for adults with asthma. Am J Med. 1993;94:564-76.

Dolovich MB, Ahrens RC, Hess DR. Device selection and outcomes of aerosol therapy: evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005;127:335-71.

DeVries TPGM, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing: a practical manual; 1994. Available at: http://apps.who.int/medicinedocs /pdf/whozip23e/whozip23e.pdf. Accessed on 12 January 2020.

How to use a standard MDI (puffer). Available at: https://www.nationalasthma.org.au/living-with-asthma/how-to-videos/how-to-use-a-standard-mdi-and-spacer. Accessed on 12 January 2020.

Roy, Battle, Lurslurchachai, Halm, Wisnivesky. Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma. Prim Care Respir J. 2011;20(2):148-54.

Melani A, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105:930-8.

Gibson PG, Ram FS, Powell H. Asthma education. Respir Med. 2003;97:1036-44.

Molimard M, Raherison C, Lignot S, Depont F, Abouelfath A, Moore N. Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care. J Aerosol Med. 2003;16(3):249-54.

Nimmo CJ, Chen DN, Martinusen SM, Ustad TL, Ostrow DN. Assessment of patient acceptance and inhalation technique of a pressurized aerosol inhaler and two breath-actuated devices. Annals Pharmacotherapy. 1993;27:922-7.

Heringa P, Lawson L, Reda D. The effect of structured education program on the knowledge and psychomotor skills of the patients using beclomethasone dipropionate aerosol for steroid dependent asthma. Health Educ Q. 1987;14:309-17.

Larsen JS, Hahn M, Ekholm B, Wick KA. Evaluation of conventional press and breathe metered-dose inhaler technique in 501 patients. J Asthma. 1994;31:193-9.

Jolly GP, Mohan A, Guleria R, Poulose R, George J. Evaluation of Metered Dose Inhaler Use technique and Response to Educational Training. Indian J Chest Dis Allied Sci. 2015;57:17-20.

Purohit AN, Patel PP, Gandhi AM, Desai MK. An evaluation of impact of educational interventions on the technique of use of metered-dose inhaler by patients. Indian J Pharmacol. 2017;49(2):194-200.