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ADVANCE Perspective: Respiratory Views

Researchers Find Gaping Hole in Quality Asthma Care

Published April 5, 2011 2:53 PM by Valerie Newitt

Most children do not know how to use their inhalers correctly. Whose fault is that? Care providers.

According to a new study from the University of North Carolina at Chapel Hill Fewer than one in 10 children with asthma use traditional inhalers correctly. While children have more success with newer inhaler designs, at best only one child in four gets it completely right, according to the findings recently published online in the journal Pediatrics.

The study, titled "Provider Demonstration and Assessment of Child Device Technique During Pediatric Asthma Visits," was funded by the National Heart Lung and Blood Institute and supported in part by a grant from the National Center of Research Resources, National Institutes of Health. According to a Newswise news release, researchers studied 296 North Carolina patients aged 8 to 16 years old who used four different devices to manage their asthma. The devices were:

  • the metered-dose inhaler (a puffer);
  • the diskus, a dry-powder inhaler delivering Advair;
  • the turbuhaler, a dry-powder inhaler delivering Pulimcort or Symbicort; and
  • the peak-flow meter, used to measure lung function.

Only 8.1 percent of children in the study performed all of the metered-dose inhaler steps correctly. Older children were more likely than younger children to get more of the metered-dose inhaler steps correct. With a diskus, 21.9 percent of children performed all steps correctly, and 15.6 percent performed all of the turbuhaler steps correctly. Children using a peak-flow meter did so correctly 23.9 percent of the time.

The researchers also found that the majority of health-care providers who participated in the study (41 providers at five clinics) did not demonstrate or assess children's use of the four devices during pediatric asthma visits.


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