Critical errors in inhaler technique among children hospitalized with asthma

Waheeda Samady*, Victoria A. Rodriguez, Ruchi Gupta, Hannah Palac, Marina Karamanis, Valerie G. Press

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Past studies have not evaluated inhaler use in hospitalized children with asthma. The objectives of this study were to evaluate inhaler technique in hospitalized pediatric patients with asthma and identify risk factors for improper use. We conducted a prospective cross-sectional study in a tertiary children’s hospital for children 2-16 years of age admitted for an asthma exacerbation, and inhaler technique demonstrations were analyzed. Of 113 participants enrolled, 55% had uncontrolled asthma, and 42% missed a critical step in inhaler technique. More patients missed a critical step when they used a spacer with mouthpiece instead of a spacer with mask (75% [51%-90%] vs 36% [27%-46%]) and were older (7.8 [6.7-8.9] vs 5.8 [5.1-6.5] years). Patients using the spacer with mouthpiece remained significantly more likely to miss a critical step when adjusting for other clinical covariates (odds ratio 6.95 [1.71-28.23], P =.007). Hospital-based education may provide teachable moments to address poor proficiency, especially for older children using a mouthpiece.

Original languageEnglish (US)
Pages (from-to)361-365
Number of pages5
JournalJournal of Hospital Medicine
Volume14
Issue number6
DOIs
StatePublished - Jun 2019

Funding

Disclosures: Dr. Gupta receives research grant support from the National Institutes of Health and the United Healthcare Group. Dr. Gupta serves as a consultant for DBV Technology, Aimmune Therapeutics, Kaleo & BEFORE Brands. Dr. Gupta has received lecture fees/honorariums from the Allergy Asthma Network & the American College of Asthma, Allergy & Immunology. Dr. Press reports research support from the Chicago Center for Diabetes Translation Research Pilot and Feasibility Grant, the Bucksbaum Institute for Clinical Excellence Pilot Grant Program, the Academy of Distinguished Medical Educators, the Develop- ment of Novel Hospital-initiated Care Bundle in Adults Hospitalized for Acute Asthma: the 41st Multicenter Airway Research Collaboration (MARC-41) Study, UCM’s Innovation Grant Program, the University of Chicago-Chapin Hall Join Research Fund, the NIH/NHLBI Loan Repayment Program, 1 K23 HL118151 01, NIH NLBHI R03 (RFA-HL-18-025), the George and Carol Abramson Pilot Awards, the COPD Foundation Green Shoots Grant, the University of Chicago Women’s Board Grant, NIH NHLBI UG1 (RFA-HL-17-009), and the CTSA Pilot Award, outside the submitted work. These disclosures have been reported to Dr. Press’ institutional IRB board. Additionally, a management plan is on file that details how to address conflicts such as these which are sources of research support but do not directly support the work at hand. The remaining authors have no conflicts of interest relevant to the article to disclose. Funding: This study was funded by internal grants from Ann and Robert H. Lurie Children’s Hospital of Chicago. Dr. Press was funded by a K23HL118151.

ASJC Scopus subject areas

  • Fundamentals and skills
  • Care Planning
  • Assessment and Diagnosis
  • Health Policy
  • Leadership and Management
  • Internal Medicine

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