[Assessment of the handling of inhaler devices: an observational study of children in primary care].
The correct use of inhaler devices is important for the efficacy of the treatment of childhood asthma. Few studies have compared the use of inhaler devices in real life, in particular in children.


OBJECTIVE
To determine whether such devices were correctly used in asthmatic children within a primary care setting.


METHODS
Three hundred and sixty-four children aged 5 to 18 years (mean+/-SD: 14.1+/-3.3) treated for at least 1 month by an inhaler device were included. During a routine visit to the doctor, the primary care physician assessed the childrens' handling of their current device, using a checklist established for each device from the package leaflet.


RESULTS
At least half of the patients made at least 1 error, regardless of the inhaler used. The best result was obtained with the Diskus (46% error-rate) and the worst with the pressurized metered-dose inhaler (pMDI) (78% error-rate). The rank order of increasing critical-error rate (at least 1 error) was as follows: Diskus (6%)<Autohaler (8%)<Aerolizer (9%)<pMDI (24%)<Turbuhaler (26%).


CONCLUSIONS
Irrespective of the type of device used, many errors are committed in real-life use. Overall, the Diskus, the Autohaler and the Aerolizer devices are more correctly used than the Turbuhaler or the pMDIs. However, it would be relatively easy to rectify all the errors identified by this study by simple educative measures.
Département de pédiatrie, centre de recherche (CEDRE), hôpital Pellegrin - Enfants, CHU de Bordeaux, France.
L
L
Malot
M
M
Molimard
A
A
Abouelfatah
S
S
Lignot
F
F
Depont
N
N
Moore
M
M
Fayon
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D009330:Nebulizers and Vaporizers; D011320:Primary Health Care; D012646:Self Administration; D011795:Surveys and Questionnaires