title: Provider demonstration and assessment of child device technique during pediatric asthma visits.
abstract: OBJECTIVE
  The purposes of this study were to (a) describe the extent to which children use metered dose inhalers, turbuhalers, diskuses, and peak flow meters correctly, and (b) investigate how often providers assess and demonstrate use of metered dose inhalers, turbuinhalers, diskuses, and peak flow meters during pediatric asthma visits.
  
  
  METHODS
  Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at 5 pediatric practices in nonurban areas of North Carolina. All of the medical visits were audiotape-recorded. Children were interviewed after their medical visits, and their device technique was observed and rated by the research assistants.
  
  
  RESULTS
  Of the patients, 296 had useable audiotape data. Only 8.1% of children performed all of the metered dose inhaler steps correctly. Older children were more likely to get more of the metered dose inhaler steps correct. Of the children, 22% performed all of the diskus steps correctly, 15.6% performed all of the turbuhaler steps correctly, and 24% performed all of the peak flow meter steps correctly. The majority of providers did not demonstrate or assess child use of metered dose inhalers, turbuhalers, diskuses, or peak flow meters during pediatric asthma visits.
  
  
  CONCLUSIONS
  There is a need for providers to demonstrate proper asthma medication and monitoring device techniques to children and to have children demonstrate to proficiency. The 2007 National Heart, Lung, and Blood Institute expert panel report on the diagnosis and management of asthma encourages providers to educate children on these techniques.
authors: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Beard Hall, CB 7360, Chapel Hill, NC 27599, USA. betsy_sleath@unc.edu
authors: Betsy
authors: B
authors: Sleath
authors: Guadalupe X
authors: GX
authors: Ayala
authors: Chris
authors: C
authors: Gillette
authors: Dennis
authors: D
authors: Williams
authors: Stephanie
authors: S
authors: Davis
authors: Gail
authors: G
authors: Tudor
authors: Karin
authors: K
authors: Yeatts
authors: Deidre
authors: D
authors: Washington
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D017028:Caregivers / Q000193:education; D002648:Child; D002908:Chronic Disease; D058995:Dry Powder Inhalers; D004522:Educational Status; D004867:Equipment Design; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers; D009657:North Carolina; D010353:Patient Education as Topic / Q000379:methods*; D010366:Peak Expiratory Flow Rate; D010817:Physician-Patient Relations; D012648:Self Care
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents