PHYSICIAN-TARGETED PROGRAM ON INHALED THERAPY FOR CHILDHOOD ASTHMA

Background: Inhaled medications are the mainstay of asthma therapy but significant deficiencies exist in the knowledge and skills of physici ans regarding use of metered-dose inhalers (MDI) and spacer devices. O bjective: We developed, implemented and evaluated the effects of a phy sician-targeted educational program on inhaled therapy in a group of p ediatric residents in our institution. Methods: Patient-directed instr uction sheets on aerosol therapy were developed on the basis of litera ture review and expert guidelines. These sewed to establish a consiste nt foundation for the educational curriculum. The program was delivere d through one-on-two teaching sessions (45 minutes). Residents were pr ovided with a summary of theoretical and practical information and wit h devices for practice (a placebo MDI, InspirEase and AeroChamber hold ing chambers, and the AeroChamber device with mask). Each session incl uded review of an educational monograph, demonstration of proper techn ique, and practice with the different devices. The program was evaluat ed by a randomized-control design. Assessment of practical skills incl uded number of correct steps for the use of MDI (maximum score, 7), In spirEase (maximum, 7) and AeroChamber (maximum, 6). Theoretical knowle dge was assessed with 25 multiple-choice questions. Results: Pretest s cores in the experimental group (n = 24) were 3.7 of 7, 1.9 of 7, and 0.3 of 6 steps correct for MDI, InspirEase, and AeroChamber devices, r espectively): and 13 of 25 for the theoretical knowledge assessment. T he control group (n = 26) had similar pretest scores. After the progra m the experimental group significantly improved in all parameters: 6.3 of 7, 5.9 of 7, and 4.5 of 6 steps correct for MDI, InspirEase, and A eroChamber devices, respectively, and 18 of 25 questions correct (p < 0.01 for all parameters). Conclusions: Implementation of a simple educ ational program among pediatric residents can significantly increase t heir skills in the use of inhalational therapy.