RT Journal Article
SR Electronic
T1 Comparison of inhalation technique with the Diskus® and Autohaler® in asthmatic children at home
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00215-2019
DO 10.1183/23120541.00215-2019
A1 A. van der Kolk
A1 N. Lammers
A1 M. Brusse-Keizer
A1 J. van der Palen
A1 J. Faber
A1 R. Spenkelink-Visser
A1 B.J. Thio
YR 2021
UL http://openres.ersjournals.com/content/early/2021/02/04/23120541.00215-2019.abstract
AB Objective Asthma is the most common chronic disease in childhood and anti-inflammatory medication is the cornerstone of treatment. Inhalers are frequently used incorrectly when demonstrated in the hospital, suggesting poor technique at home. We aimed to: 1) Compare daily inhalation technique with the Diskus® and Autohaler® in asthmatic children by filming inhalations at home; 2) Compare daily inhalation technique with technique demonstrated in the hospital.Methods We performed a randomised study in asthmatic children (6–18 years) from the outpatient clinic of MST hospital from July 2014 to April 2016. Children received inhalation instructions for the Diskus® and Autohaler® and were randomised to use one device in the morning and the other in the evening. During the 28-days study period, inhalations were filmed at home and subsequently demonstrated in the hospital. All inhalations were checked for 7 critical errors per device.Results A total of 636 videos with the Diskus® and 663 with the Autohaler® were provided by 27 children. The most common critical error in daily-life was an incorrect device position during preparation of the Diskus® (n=271) and an insufficiently deep inhalation (n=39) using the Autohaler®. Percentage of correct days using the Diskus® was 44%, compared to 96% with the Autohaler® (p<0.001). The two most common errors with the Diskus® were made at least twice as often at home than in the hospital.Conclusion Inhalation technique at home was markedly better with the Autohaler® than with the Diskus®. Pediatricians should be aware that hospital-based demonstrations can overestimate daily inhalation technique with the Diskus®.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of Interest: Dr. van der Kolk has nothing to disclose.Conflict of Interest: Dr. Thio has nothing to disclose.Conflict of Interest: Dr. Faber has nothing to disclose.Conflict of Interest: Dr. van der Palen has nothing to disclose.Conflict of Interest: Dr. Brusse-Keizer has nothing to disclose.Conflict of Interest: Dr. Lammers has nothing to disclose.Conflict of Interest: Dr. Spenkelink-Visser has nothing to disclose.