TUESDAY, April 30, 2019 (Pharmacist's Briefing) -- Child and parent confidence are poor proxies for proper inhaler use among African-American children with asthma, according to a study published online April 30 in the Annals of Allergy, Asthma & Immunology.
Anna Volerman, M.D., from the University of Chicago, and colleagues conducted an observational study during 2016 to 2017 in four Chicago public charter schools with a predominantly African-American (97 percent) and low-income (82 percent) student population. Children rated their comfort with independently using the metered dose inhaler (MDI), and parents completed a questionnaire about confidence in their child's ability to use the inhaler properly. The children were then asked to use an inhaler comprising a placebo MDI and spacer with mouthpiece.
The researchers found that 71 percent of the children were confident that they could properly use inhalers independently. Ninety-two percent of parents reported confidence in their child's proper inhaler use. Participants completed a mean of 3.65 steps correctly for inhaler technique. Ninety-seven percent of children misused their inhaler; one child (2 percent) demonstrated mastery. Neither child nor parent confidence were good proxies for proper technique. Most children and parents overestimated the child's ability (children, 67 percent; parents, 89 percent).
"Objective measures should be utilized in health care encounters to evaluate inhaler technique, as correcting inhaler misuse is critical to improve outcomes among African-American youth disproportionately affected by asthma," the authors write.