Assessment of the ability of asthmatic children to use a breath-actuated pressurized inhaler

Background. - Poor inhaler technique in asthmatics is well documented. The objective of this study was to evaluate the influence of reading the instru ction leaflet and the consultant's explanations on the use of the new breat h-actuated inhaler (Autohaler(R) 3M). Methods. - In this study were participating 379 asthmatic children and adol escents, aged from four to 17 years (mean age: 10; 64% boys), recruited by 80 pediatricians. The use of the Autohaler(R) device was considered to be c orrect if the shaking, lip position, deep inhalation and apnea were all pro perly performed. Results. - The Autohaler(R) was used correctly by 42% of the subjects simpl y after reading the instruction leaflet (phase I), and by 75% of the subjec ts who, having failed phase I, received the consultant's explanations (phas e II). At the end of phases I and II, the device was correctly used by 84% of the subjects. In multivariate analysis, those under the age of nine year s and those with no prior use of inhaler systems accounted for a significan t amount of the incorrect use of the Autohaler(R) during phase I. In phase II, only the fact of being less than nine years old was significantly relat ed to incorrect use. Conclusion. - More than four-fifths of the asthmatic children and adolescen ts properly used the Autohaler(R) after merely reading the instructions and after receiving additional explanation from the consultant. The marked imp rovement obtained after medical explanations underlines the essential educa tive role of the physician when prescribing. Young children require specifi c training and particularly careful attention. (C) 1999 Editions scientifiq ues et medicales Elsevier SAS.