title: Pressurised metered dose inhaler-spacer technique in young children improves with video instruction.
abstract: The importance of good device technique to maximise delivery of aerosolised medications is widely recognised. Pressurised metered dose inhaler (pMDI)-spacer technique was investigated in 122 children, aged 2-7 years, with asthma. Eight individual steps of device technique were evaluated before and after viewing an instructional video for correct device technique. Video measurements were repeated every three months for nine months. Device technique improved directly after video instruction at the baseline study visit (p < 0.001) but had no immediate effect at subsequent visits. Additionally, pMDI-spacer technique improved with successive visits over one year for the group overall as evidenced by increases in the proportion of children scoring maximal (p = 0.02) and near-maximal (p = 0.04) scores.
  
  
  CONCLUSIONS
  Repeated video instruction over time improves inhaler technique in young children.
  
  
  BACKGROUND
  • Correct device technique is considered essential for sufficient delivery of inhaled medication. • Poor inhaler use is common in young asthmatic children using pressurised metered dose inhalers and spacers. What is New: • Video instruction could be used as a strategy to improve device technique in young children.
authors.affiliation: Clinical Sciences, Telethon Kids Institute, Subiaco, Western Australia, Australia, 6008.
authors.forename: Nicole
authors.initials: N
authors.lastname: Shaw
authors.affiliation: Department of Respiratory Medicine, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia, 6008.|School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia, 6009.
authors.forename: Peter
authors.initials: P
authors.lastname: Le Souëf
authors.affiliation: Clinical Sciences, Telethon Kids Institute, Subiaco, Western Australia, Australia, 6008.
authors.forename: Lidija
authors.initials: L
authors.lastname: Turkovic
authors.affiliation: Clinical Sciences, Telethon Kids Institute, Subiaco, Western Australia, Australia, 6008.
authors.forename: Lucy
authors.initials: L
authors.lastname: McCahon
authors.affiliation: Clinical Sciences, Telethon Kids Institute, Subiaco, Western Australia, Australia, 6008.|Department of Respiratory Medicine, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia, 6008.|School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia, 6009.|Centre for Cell Therapy and Regenerative Medicine, The University of Western Australia and Harry Perkins Institute, Nedlands, Western Australia, Australia, 6009.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kicic
authors.affiliation: Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia, 4029.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Sly
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia, 6009.
authors.forename: Sunalene
authors.initials: S
authors.lastname: Devadason
authors.affiliation: Clinical Sciences, Telethon Kids Institute, Subiaco, Western Australia, Australia, 6008. andre.schultz@health.wa.gov.au.|Department of Respiratory Medicine, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia, 6008. andre.schultz@health.wa.gov.au.|School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia, 6009. andre.schultz@health.wa.gov.au.
authors.forename: André
authors.initials: A
authors.lastname: Schultz
mesh_terms: D000280:Administration, Inhalation; D000367:Age Factors; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers / Q000592:standards*; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D012646:Self Administration / Q000592:standards
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol
keywords: Aerosol; Asthma; Children; Drug delivery; Salbutamol