Effectiveness of the different methods of inhalation drugs delivery in children with bronchial asthma

S.M. Nedelska, O.D. Kuznietsova, N.M. Taran, A. Aleschenko

Abstract


Aim of the work — to evaluate the effectiveness of inhalation technique when using different types of inhalers (dry powder inhalers — Turbuhaler, Diskus), metered-dose inhalers, breath-actuated inhalers — Easyhaler). Materials and methods. 45 patients aged 6–17 years underwent the evaluation of inhalation technique accuracy with the use of In-Check-Dial — apparatus, which imitates the airway resistance that should be overcome during inspiration through different inhaler types, and measure inspiration velocity. Incidence of mistakes was studied in different age groups. Results. 80 % of children aged 6–7 years made mistakes while using Turbuhaler, 73.3 % — metered-dose inhaler, 60 % — Easyhaler. There were no mistakes in patients making inhalation by means of Diskhaler. 100 % of children aged 12–14 years incorrectly used metered-dose inhaler. Easyhaler was incorrectly used in 66.6 % of cases, Diskhaler — in 26.6 %. Among elder group, incidence of mistakes when making inhalations through Turbuhaler was lower — 40 % in 12–14-year-old group and 25 % — in 15–17-year-old (р < 0.05). Children of 15–17 years old are able to use Turbuhaler and Diskus (mistakes in 33.3 and 46.6 %, respectively). At the same time, none of the patients have done the correct inhalation by means of metered-dose inhaler, 93.3 % of the patients have mistakes when using Easyhaler. Conclusions. The incidence of mistakes depends on the age and inhaler type and reaches 26–100 %. Minimal quantity of mistakes is seen for Diskus (in all age groups), maxi­mal — for metered-dose inhaler. For the purpose of optimal inhaler choice in a child with bronchial asthma, it is advisable to measure the inspiratory flow with the help of In-Check-Dial before therapy administration.

Keywords


bronchial asthma; children; inhalation technique; choice of delivery device

References


Regeza MS, Regeza MM, Furdichko LO, Kolіnetska MA, Mironenko SІ. Bronkhial’naia astma. Monografiia [Bronchial Asthma. Monograph]. Lviv; 2012. 147p. (in Ukrainian).

Ohotnіkova OM. Bronhіal asthma in children. Mistectvo lіkuvannya. 2011;1(77):41-51. (in Ukrainian).

Rechkyna OO, Doroshenkova AS. Mistakes in the usage of metered dose inhaler in childhood bronchial asthma. Astma ta alerhiya. 2014;4:28-32. (in Ukrainian).

Uniform clinical guideline of primary, secondary (specialized) medical care “Bronchial asthma in children”. Available from: www.moz.gov.ua/docfiles/ UKPMD_Astma_d_ty_DEC.pdf.

Tsoy AN. Factors of effectiveness of inhalation therapy and choice of dry powder inhaler. Pul’monolohiia i allerholohiia. 2009;3:16-22. (in Russian).

Westerik JAM, Carter V, Chrystyn H, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma. 2016;53(3):321-9. doi: 10.3109/02770903.2015.1099160.

Lavorini F, Mannini C, Chellini E. Challenges of inhaler use in the treatment of asthma and chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2012;7:495-502. doi: 10.2147/COPD.S32674, PMCID: PMC3413176.

Global strategy for asthma management and prevention (revised 2015). Available from: ginasthma.org/wp-content/uploads/2016/04/GINA-2016-main-report_tracked.pdf.

Haughney J, Sims E, Holohan J. Improving clinician-patient communication in asthma: the HARP project. Allergy. 2010 Apr;65(4):413-4. doi: 10.1111/j.1398-9995.2009.02127.х. PMID: 20146731.

Aalderen WM, Garcia-Marcos L, Gappa M, et al. How to match the optimal currently available inhaler device to an individual child with asthma or recurrent wheeze. Primary Care Respiratory Medicine. 2015;25:14088. doi: 10.1038/npjpcrm.2014.88.

Self TH, Wallace JL, George CM, Howard-Thompson A, Schrock SD. Inhalation therapy: Help patients avoid these mistakes. Int J Chron Obstruct Pulmon Dis. 2012;7:495-502. doi: 10.2147/COPD.S32674. PMCID: PMC3413176.

Rootmensen GN, van Keimpema AR, Jansen HM, de Haan RJ. Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method. Journal of aerosol medicine and pulmonary drug delivery. 2010 Oct;23(5):323-8. doi: 10.1089/jamp.2009.0785.

Sanchis J, Gich I, Pedersen S. Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time? Chest. 2016;150(2):394-406. doi: 10.1016/j.chest.2016.03.041.

Press VG, Pincayage AT, Pappalardo AA, et al. The Chicago Breathe Project: a regional approach to improving education on asthma inhalers for resident physicians and minority patients. J Natl Med Assoc. 2010;102:548-555. PMID: 20690317.




DOI: https://doi.org/10.22141/2224-0551.12.1.2017.95017

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