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 VO 7 IS 2 A1 van der Kolk, Annelies A1 Lammers, Natasja A1 Brusse-Keizer, Marjolein A1 van der Palen, Job A1 Faber, Joyce A1 Spenkelink-Visser, Reina A1 Thio, Bernard J. YR 2021 UL https://publications.ersnet.org//content/7/2/00215-2019.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 and 2) compare daily inhalation technique with technique demonstrated in the hospital.Methods We performed a randomised study in asthmatic children (aged 6–18 years) from the outpatient clinic of Medisch Spectrum Twente hospital (Enschede, The Netherlands) 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-day study period, inhalations were filmed at home and subsequently demonstrated in the hospital. All inhalations were checked for seven critical errors per device.Results 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. Paediatricians should be aware that hospital-based demonstrations can overestimate daily inhalation technique with the Diskus.Inhalation technique at home is markedly better with the Autohaler than with the Diskus. Paediatricians should be aware that hospital-based demonstrations can overestimate daily inhalation technique with the Diskus. https://bit.ly/3cYK4eq