Physician-targeted program on inhaled therapy for childhood asthma

• Published in: Journal of allergy and clinical immunology Vol. 95; no. 4; pp. 818 - 823
• Main Authors: Amirav, Israel, Goren, Avner, Kravitz, Richard M., Pawlowski, Nicholas A.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.1995; Elsevier
• Subjects: Administration, Inhalation; Asthma; Asthma - drug therapy; asthma education; Biological and medical sciences; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Child, Preschool; Education, Medical; Humans; inhaled therapy; Internship and Residency; Medical sciences; metered-dose inhaler; Nebulizers and Vaporizers; Pediatrics - education; Pharmacology. Drug treatments; Randomized Controlled Trials as Topic; Respiratory system; metered-dose inhaler; MDI; inhaled therapy; asthma education; Asthma; Human; Drug; Drug compliance; Educational program; Treatment; Respiratory disease; Education; Obstructive pulmonary disease; Child; Aerosol batcher; Inhalation
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(95)70124-9

Background: Inhaled medications are the mainstay of asthma therapy, but significant deficiencies exist in the knowledge and skills of physicians regarding use of metered-dose inhalers (MDI) and spacer devices. Objective: We developed, implemented, and evaluated the effects of a physician-targeted educational program on inhaled therapy in a group of pediatric residents in our institution. Methods: Patient-directed instruction sheets on aerosol therapy were developed on the basis of literature review and expert guidelines. These served to establish a consistent foundation for the educational curriculum. The program was delivered through one-on-two teaching sessions (45 minutes). Residents were provided with a summary of theoretical and practical information and with devices for practice (a placebo MDI, InspirEase and AeroChamber holding chambers, and the AeroChamber device with mask). Each session included review of an educational monograph, demonstration of proper technique, and practice with the different devices. The program was evaluated by a randomized-control design. Assessment of practical skills included number of correct steps for the use of MDI (maximum score, 7), InspirEase (maximum, 7) and AeroChamber (maximum, 6). Theoretical knowledge was assessed with 25 multiple-choice questions. Results: Pretest scores 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, respectively, and 13 of 25 for the theoretical knowledge assessment. The control group ( n = 26) had similar pretest scores. After the program 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 AeroChamber devices, respectively, and 18 of 25 questions correct ( p < 0.01 for all parameters). Conclusions: Implementation of a simple educational program among pediatric residents can significantly increase their skills in the use of inhalational therapy. (J A LLERGY C LIN I MMUNOL 1995;95:818-23.)