title: Assessment of skills using a spacer device for a metered-dose inhaler and related independent predictive factors in caregivers of asthmatic preschool children.
abstract: BACKGROUND
  The correct use of inhalation devices is essential for successful therapy. We aimed to evaluate the skills in the use of a spacer device with an metered-dose inhaler (MDI) and factors that influence this skill in asthmatic preschool children's caregivers.
  
  
  METHODS
  The caregivers of 12-month-old to 72-month-old children were interviewed face-to-face and filled out questionnaires. To assess use of the spacer device, we asked the caregivers to verbally describe and demonstrate how they used the device.
  
  
  RESULTS
  A total of 244 patients were included in the study, and 142 (58.2%) of the caregivers demonstrated every step for using the spacer device. The most frequently mistaken step was waiting for 30 seconds for the second puff after the first puff. When statistically significant and clinically important parameters were analyzed in a logistic regression model, the parameters satisfaction with the spacer device (odds ratio [OR] 29.9; 95% confidence interval [CI], 7.64 to 117.39; p < 0.001), a university graduate (OR 13.5; 95% CI, 3.36 to 54.8; p < 0.001), family monthly income of more than US$1500 (OR 5.3; 95% CI, 2.16 to 13.39; p < 0.001), device training provided by a clinical trainer (OR 12.3; 95% CI, 4.82 to 31.73; p < 0.001), regular follow-ups (OR 3.6; 95% CI, 1.57 to 8.47; p = 0.003), and the absence of a severe attack during the last year (OR 6.5; 95% CI, 2.64 to 16.43; p < 0.001) were found to be independent factors that affected the correct demonstration of the device.
  
  
  CONCLUSIONS
  The factors most effective in the correct use of the MDI spacer device were satisfaction with the device, training having been given by a clinical trainer on this subject, and the caregiver being a university graduate.
authors.affiliation: Department of Pediatric Allergy and Immunology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Topal
authors.affiliation: Department of Pediatric Allergy and Immunology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Mehmet Halil
authors.initials: MH
authors.lastname: Celiksoy
authors.affiliation: Department of Pediatric Allergy and Immunology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Catal
authors.affiliation: Department of Pediatric Allergy and Immunology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: Muhammed S
authors.initials: MS
authors.lastname: Sinanoglu
authors.affiliation: Department of Pediatric Allergy and Immunology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: Habib Tadayyon Einaddin
authors.initials: HT
authors.lastname: Karakoc
authors.affiliation: Department of Pediatric Allergy and Immunology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Sancak
authors.affiliation: Department of Pediatric Allergy and Immunology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Fadıl
authors.initials: F
authors.lastname: Ozturk
mesh_terms: D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004864:Equipment and Supplies / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D012959:Socioeconomic Factors; D014421:Turkey
keywords: MDI; asthma; children; metered-dose inhaler; preschool; skill; spacer device