International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 6, Issue 8 (2020)

How properly are our children receiving inhalational therapy for bronchial asthma


Krishna Keshav, Girijanand Jha, Binod Kumar Singh, Saroj Kumar, Sushil Kumar Pathak

Background: Inhalational therapy is the mainstay of treatment in children with asthma. However, the use of inhalational therapy needs proper evaluation as poor handling of such devices and wrong inhalation technique are associated with decreased delivery of the drug and hence poor disease control. It is therefore important to overcome the drawbacks in inhalation technique by knowing the issues related to correct usage of these medical devices by children or their caregivers in Bronchial Asthma. Methodology: We conducted this prospective observational study over a period of 1.5 years from January 2019 to June 2020 at O.P.D and Emergency of Pediatrics deptt at N.M.C.H, Patna including children of age 5-16 years with Bronchial asthma who were using inhalational devices for atleast one month. Results: Mean age of the study population was 7.9 years (S.D 2.4 years). Male: Female ratio was 1.3:1. Mean age at diagnosis was 7.1 years (S.D 2.1 years). Mean duration of using the inhalational device was 6.2 months (S.D 1.7 months). Out of the 162 patients studied, only 27.2% could use their device properly. MDI was the commonest device being used (57.4%) followed by nebulizer (26.5%). However, MDI was also the most improperly used inhalational device (78.5%) while children receiving nebulisation therapy had the least number of errors (62.8%). The most common error in MDI was failure to shake the MDI, in DPI/Rotahaler it was inadequate breath accentuation and in nebulisation it was poor fitting of the mask. Children were educated about proper use of their device by a Doctor (54.9%) followed by nurses/hospital staffs (22.8%) & pharmacists (22.2%). In univariate analysis, we found following to significantly increase the risk of erroneous use: either parent being illiterate, low socioeconomic status, inhabitation in rural area, female sex, training about usage by personnel other than a Doctor and device usage for >3 months. Conclusion: Majority of the children (62.8%) were not correctly using their inhalational devices. Proper education to patients/parents on correct usage may not only improve control of the symptoms of the disease but might also allow dose reduction in the long term.
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