Abstract
In order for inhaled corticosteroids to be delivered adequately to the airways they require patients to take them regularly using an effective technique. Patients often have a poor inhaler technique, and this has been shown to result in sub-optimal asthma control. It is important for all clinicians prescribing inhaled medication to be experienced in the correct technique, and take time to train children so that they have mastered corrected inhaler technique. Using Teach to Goal or teach back methodology is a simple and effective way to provide this in the clinic setting. More than one training session is typically needed before children can master correct inhaler technique. Adherence to inhaled therapy has been shown to be sub-optimal in pediatric populations, with studies showing an average rate of around 50%. Subjective methods of measuring adherence have been shown to be inaccurate and overestimate rates. The advent of new technology has allowed adherence rates to be measured electronically, and it has been shown that regular feedback of these data can be effective at improving asthma control. New mobile apps and smart technology aim to engage patients and families with their asthma care. Effective use of these apps in collaboration with health care professionals has a vast potential to improve adherence rates and inhaler technique, resulting in improved asthma control.
Highlights
Improving Aerosol TherapyWe address each of these two fundamental aspects of asthma care (incorrect inhaler technique, poor adherence to inhaled corticosteroids (ICS)) through key questions such as;
Clinicians who at some time have to prescribe asthma inhalers should be properly trained in both their use and how to teach children to use inhalers correctly
Poor asthma control can be attributed to an incorrect inhaler technique as previously described, but across all age groups adherence to therapy remains a significant, modifiable barrier to effective treatment
Summary
We address each of these two fundamental aspects of asthma care (incorrect inhaler technique, poor adherence to ICS) through key questions such as;. [3] what evidence is there that addressing the problem results in clinical benefit?. The prominent reason for asthma control remaining poor for many children is that the ICS does not reach the targeted airways. This occurs if the ICS medication in not taken (poor adherence) and /or if there is incorrect and poor inhaler technique. Poor inhaler technique with poor drug delivery incurs the medication cost but with a reduced potential clinical benefit in terms of reduced asthma attacks or asthma control
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