Observation of the knowledge and use of inhalers in children

Goubau, Christophe [UCL] Audag, Nicolas [UCL] Chanel, Marie-Line Godding, Véronique Liistro, Giuseppe [UCL] Reychler, Gregory [UCL]

Background: A poorly performed inhalation technique is a well-known problem in adult patients but it is less documented in paediatric patients. Aim: This study aimed to evaluate the proper use of pressurized metered dose inhalers (pMDI) and dry powder inhalers (DPI) in children and their parents. Method: Thirty-nine children with chronic respiratory disease and already under inhalation therapy for at least three months were recruited prospectively during routine clinics. These children had received a training when treatment was started. A specific questionnaire evaluated their knowledge regarding the inhaled treatment and inhalation technique. The inhalation manoeuver was divided in maximum 17 steps and each step was assessed separately (score of 0 (=not performed) to 2 (=perfectly performed)). Results: Children (20F/19M) were 4.8±4.9 years old. Eighty seven per cent used a pMDI, 64% of whom with an aerosol chamber. Fifty six and 26% of children did not know the medication name and the colour of the device, respectively. The steps of the manoeuver were incorrectly or not performed in 9% and 27% of children using a pMDI. This proportion was similar (8% vs 31%) with the use of an aerosol chamber. The manoeuver was correct in 83% of steps for children using DPI. No error was detected for 50, 73 and 74% of children using pMDI, pMDI + chamber and DPI, respectively. Conclusion: The knowledge and technique of inhalation therapy is imperfect in children even after a routine education.