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Development of a Scale to Measure Children's Metered-Dose Inhaler and Spacer Technique

1996; Elsevier BV; Volume: 77; Issue: 3 Linguagem: Inglês

10.1016/s1081-1206(10)63258-9

1534-4436

Linda Boccuti, Marianne Celano, Robert J. Geller, Keith Phillips,

Inhalation and Respiratory Drug Delivery

Background A measure of metered dose inhaler (MDI) and spacer technique would help health care providers to estimate the degree to which technique may confound clinical efficacy of inhaled medications. Objective Our purpose was to extend earlier efforts to develop a rating scale to asses the accuracy of children's technique in using an MDI with three of the newer spacer devices. Methods Subjects were children, 7 to 17 years old, with moderate to severe asthma attending a follow-up appointment in an outpatient specialty clinic for asthma. Nurse practitioners and /or physicians completed a rating scale (MDI Checklist) for 50 children using an Optihaler spacer, 29 using Azmacort, and 21 using InspirEase. Results Depending on the spacer used, 14% to 26% of the children failed to demonstrate the critical skills for delivering medicine to the conducting airways, with InspirEase group showing the best results. Items vary in difficulty (percent correct). The scale has excellent internal consistency reliability for Optihaler. Conclusions The scale can be used (1) by health care providers to instruct patients or colleagues, (2) by parents to monitor and correct their children's MDI/spacer technique, and (3) by researchers to estimate drug delivery in studies of clinical outcome or adherence. A measure of metered dose inhaler (MDI) and spacer technique would help health care providers to estimate the degree to which technique may confound clinical efficacy of inhaled medications. Our purpose was to extend earlier efforts to develop a rating scale to asses the accuracy of children's technique in using an MDI with three of the newer spacer devices. Subjects were children, 7 to 17 years old, with moderate to severe asthma attending a follow-up appointment in an outpatient specialty clinic for asthma. Nurse practitioners and /or physicians completed a rating scale (MDI Checklist) for 50 children using an Optihaler spacer, 29 using Azmacort, and 21 using InspirEase. Depending on the spacer used, 14% to 26% of the children failed to demonstrate the critical skills for delivering medicine to the conducting airways, with InspirEase group showing the best results. Items vary in difficulty (percent correct). The scale has excellent internal consistency reliability for Optihaler. The scale can be used (1) by health care providers to instruct patients or colleagues, (2) by parents to monitor and correct their children's MDI/spacer technique, and (3) by researchers to estimate drug delivery in studies of clinical outcome or adherence.