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Hospital offers ‘teachable moment’ to correct poor asthma inhaler technique among young

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Being in hospital could provide an opportunity for nurses to improve poor inhaler technique among young patients admitted for asthma, according to US researchers.

The call comes on the back of study in which the researchers from Chicago found that critical errors in inhaler technique were common.

“Improper inhaler technique can contribute to children having uncontrolled asthma”

Waheeda Samady

The study evaluating inhaler technique in children hospitalised for asthma found that nearly half of participants demonstrated improper inhaler use, meaning they were not taking in the full dose.

The study authors discovered that, among participants, adolescents most commonly displayed critical errors in inhaler technique and also often skipped using a spacer.

Out of 113 study participants, aged two to 16 years of age, 42% missed at least one critical step in their inhaler technique.

Researchers found that 18% did not use a spacer device with their inhaler, and that these patients were mostly older.

They noted that previous studies had shown that adding a spacer device to an inhaler increased the amount of asthma medication a patient takes in from 34% to 83%.

They also highlighted that in their study they found more patients missed a critical step when they used a spacer with mouthpiece instead of a spacer with mask.

“Hospital-based education may provide teachable moments to address poor proficiency, especially for older children using a mouthpiece,” said the study authors.

The findings from the study, which was carried out at the Ann & Robert H. Lurie Children’s Hospital of Chicago, were published in the Journal of Hospital Medicine.

“Children with asthma can lead full lives if they receive the right medication at the appropriate dose”

Waheeda Samady

Lead author Dr Waheeda Samady said: “We know that asthma can be well managed in the majority of patients and using your inhaler correctly is key factor to managing asthma.

“Improper inhaler technique can contribute to children having uncontrolled asthma and needing to come to the hospital for their asthma,” said Dr Samady.

She said: “Our study suggests that as healthcare providers we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it.”

“We see that our adolescent patients, who are transitioning to independent medication management, still need close monitoring to make sure they use their inhaler and spacer appropriately to achieve optimal asthma control,” she said.

“Teens may feel that using a spacer is only for younger children, but using a spacer is recommended for adults as well,” she noted.

She added: “Children with asthma can lead full lives if they receive the right medication at the appropriate dose, which is why correct inhaler technique is so crucial.”

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