Asthma is the most common chronic disease of childhood, and using an asthma inhaler is often a first step toward medical autonomy for a child with asthma. But the value of technology depends on how you use it, and children — and adults — need to use their inhalers correctly for the devices to help.
Dr William C Anderson III, the first author on the study and co-director of the multidisciplinary asthma clinic at the Children’s Hospital Colorado, said that there are at least seven steps in using an inhaler correctly: Eighty-four per cent of the patients did not wait the 30 seconds that the researchers felt was the absolute minimum time between inhalations. More than 50 per cent waited less than 15 seconds.
Dr Francine M Ducharme, a professor of pediatrics and social and preventive medicine at the University of Montreal, has studied the efficacy and safety of asthma management. When a treatment of known efficacy doesn’t work for a child, she said, the four major reasons are inadequate technique, suboptimal adherence to the regimen, other coexisting medical issues, or environmental triggers .
Everyone, adult or child, should use a spacer, she said, to make sure the drug is properly inhaled into the lungs rather than deposited in the mouth. Parents may believe their children have mastered the technique and learned all the steps, Anderson said, but “we need the parents to be there to observe them and make sure they’re taking it correctly,” especially for children under 12. In fact, among the patients in the study, he said, although there was “across the board poor inhaler technique,” the group with the best technique was the 4- to 11-year-olds; the researchers can’t say why, but their working theory is parental supervision.
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