title: Assessment of inhalation technique in children with asthma, Abha, Saudi Arabia.
abstract: The inhalation technique of asthma in children was assessed using the criteria defined by the standardized inhaler checklist of the Netherlands Asthma Foundation and Dutch asthma foundation. Four hundred and thirty seven newly referred patients to chest clinic, department of pediatric, Assir Central Hospital, Southwestern Saudi Arabia were instructed to demonstrate their inhalation technique and to fill out a questionnaire related to the inhalation instructions received before their referral.
  
  
  RESULTS
  Four hundred and thirty seven patients newly referred for evaluation of their asthma (5-12 years of age with mean age of 7.16+1.69 years, 202 (46.2%) girls, 235 (53.8%) boys were included in the study. Two hundred two (46.2%) patients use MDI. The remaining (53.8%) patients use the DPI, 123 (52.35%) of them use turbohalers while 112 (47.65%) use diskhalers. Only 36 patients (8.2 %) completed the assessment without making any mistake. Of the remainders, 399 (91.8%) made one or more mistakes. Of the MDI users, eleven patients (5.4%) performed correctly all the steps, and 54 (26.7%) performed correctly four or more steps. Ten (8.9%) of the diskhaler users performed all the steps correctly and forty nine (43.8) performed correctly four or more steps. Fifteen (12 2%) of the turbohaler users performed correctly all the steps and ninety five (77.2%) performed correctly four or more steps. One hundred five of the male patients (44.7%), performed correctly more than three steps as compared to 93 of the female patients (46.5) with p value=0.704. One hundred and one patients (67.3%) between the age of 8-12 years performed more than three steps correctly as compared to 97 (33.8%) of patients aged 5-7 years (p=0.001).
  
  
  CONCLUSIONS
  In conclusion, many asthmatic children use their inhaler devices too poorly with the result of an unreliable drug delivery. Turbohaler device inhalation technique was the easiest, followed by diskhaler then lastly the MDI. Education of asthmatic children and their families is highly needed to make sure the patient perform the correct inhalation technique.
authors.affiliation: Pediatric Pulmonology Division, Department of Paediatrics, College of Medicine and Health Sciences, King Khalid University, Abha Assir central Hospital, Abha, K.S.A. Fariss2000@yahoo.com
authors.forename: M A
authors.initials: MA
authors.lastname: Alshehri
mesh_terms: D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D012138:Respiratory Therapy / Q000379:methods*; D012529:Saudi Arabia; D011795:Surveys and Questionnaires