title: Daily Observations of Nebuliser Use and Technique (DONUT) in children with cystic fibrosis.
abstract: Cystic fibrosis (CF) caregivers focus on correct inhalation technique for nebulisers as this is essential to optimize efficacy of inhaled drugs. However, little is known on this nebuliser technique of patients at home.
  
  
  
  Three "hidden" video registrations were made of 32 children with CF (6-18years) nebulising at home. Videos were randomly scored on inhalation technique items using nebuliser-specific checklists and a total score was calculated.
  
  
  
  Median nebuliser technique was 91.9% of max score. Nebuliser technique was perfect (score 100%) in 23.3% of the patients and incorrect (score 0%) in 13.3%. Most mistakes were made in the required optimal breathing pattern.
  
  
  
  Most CF patients had good nebuliser technique on a day-to-day basis. However, errors observed likely resulted in reduced treatment efficacy and, in 13%, no treatment at all. Regular "real life" evaluation by the CF-team can improve inhaled therapy substantially.
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: a.c.bos@erasmusmc.nl.
authors.forename: Aukje C
authors.initials: AC
authors.lastname: Bos
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: h.tiddens@erasmusmc.nl.
authors.forename: Harm A W M
authors.initials: HA
authors.lastname: Tiddens
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: kirby.tongminh@gmail.com.
authors.forename: Kirby
authors.initials: K
authors.lastname: Tong Minh
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: i.heeres@erasmusmc.nl.
authors.forename: Inge
authors.initials: I
authors.lastname: Heeres
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: j.overweel@erasmusmc.nl.
authors.forename: Joke L
authors.initials: JL
authors.lastname: Overweel-Uijterlinde
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: n.kok@erasmusmc.nl.
authors.forename: Annelies E
authors.initials: AE
authors.lastname: Kok
authors.affiliation: Department of Biostatistics, Erasmus MC, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: e.andrinopoulou@erasmusmc.nl.
authors.forename: Eleni-Rosalina
authors.initials: ER
authors.lastname: Andrinopoulou
authors.affiliation: Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre (MC)-Sophia Children's Hospital, Wytemaweg 80, 3015CN Rotterdam, The Netherlands. Electronic address: h.janssens@erasmusmc.nl.
authors.forename: Hettie M
authors.initials: HM
authors.lastname: Janssens
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017028:Caregivers; D057189:Checklist / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data*; D009426:Netherlands; D011897:Random Allocation; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods; D012648:Self Care / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Children; Cystic fibrosis; Inhalation technique; Nebuliser