The Journal of Allergy and Clinical Immunology
Volume 94, Issue 4 , Pages 669-675 , October 1994

What do pediatricians in training know about the correct use of inhalers and spacer devices?

  • Israel Amirav, MD
  • ,
  • Avner Goren, MD
  • ,
  • Nicholas A. Pawlowski, MD

      Affiliations

    • Corresponding Author InformationReprint requests: Nicholas A. Pawlowski, MD, Allergy Section, Room 8034, Children's Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA 19104-4399.

Received 24 August 1993 ,Revised 12 November 1993 ,Accepted 2 March 1994.

References 

  1. Evans R, Mullally DI, Wilson RW, et al.  National trends in the morbidity and mortality of asthma in the US: prevalence, hospitalization and death from asthma over two decades: 1965–1984. Chest. 1987;91:65S–74S (Suppl)
  2. Centers for Disease Control . Asthma—United States, 1980–1987. MMWR. 1990;39:493–497
  3. Benatar SP. Fatal asthma. N Engl J Med. 1986;314:423–428
  4. Speight ANP, Lee DA, Hey EN. Underdiagnosis and undertreatment of asthma in childhood. BMJ. 1983;286:1253–1256
  5. Buist AS. Asthma mortality: what have we learned?. J Allergy Clin Immunol. 1989;84:275–283
  6. In: National Asthma Education Program. Expert panel report: international consensus report on diagnosis and management of asthma. 3rd ed. Pub no 92-3091. Bethesda, Maryland: US Department of Health and Human Services, National Institutes of Health; 1992;
  7. Altman LK. Rise in asthma deaths is tied to ignorance of many physicians. The New York Times. 4 May 1993;3; sec C
  8. Guidelines for the diagnosis and management of asthma. J Allergy Clin Immunol. 1991;88:425–534
  9. Levison H, Reilly PA, Worsley GH. Spacing devices and metered-dose inhalers in childhood asthma. J Pediatr. 1985;107:662–668
  10. Kelling JS, Strohl KP, Smith RL, Altose MD. Physician knowledge in the use of canister nebulizers. Chest. 1983;4:612–614
  11. Burton AJ. Asthma inhalation devices: what do we know?. BMJ. 1984;288:1650–1651
  12. Tal A, Paul M, Weitzman S. Proper use of metered-dose inhalers: the role of the primary care physician. Isr J Med Sci. 1987;23:168–170
  13. Mickle TR, Self TH, Farr GE, Bess DT, Tsiu SJ, Caldwell FL. Evaluation of pharmacists' practice in patient education when dispensing a metered-dose inhaler. DICP. 1990;24:927–930
  14. Guidry GG, Brown WD, Stogner SW, George RB. Incorrect use of metered-dose inhalers by medical personnel. Chest. 1992;101:31–33
  15. Newhouse MT, Dolovich MB. Control of asthma by aerosols. N Engl J Med. 1986;315:870–874
  16. Sly PD, LeSouef PN. Inhaled therapy in pediatrics. J Paediatr Child Health. 1991;27:7–10
  17. Hemstreet MP. The effective use of the metered dose inhaler (MDI) in the pediatric asthmatic patient. Am J Asthma Allergy Pediatr. 1991;4:145–150
  18. Newman SP, Pavia D, Clarke SW. How should a pressurized beta-adrenergic bronchodilator be inhaled?. Eur J Res Dis. 1981;62:3–21
  19. Dolovich MB, Ryan G, Newhouse MT. Aerosol penetrance into the lung: influence on airway responses. Chest. 1981;80:834S–836S (Suppl)
  20. Lee HS. Proper aerosol inhalation technique for delivery of asthma medications. Clin Pediatr. 1983;22:440–443
  21. Newman SP. Aerosol deposition considerations in inhalation therapy. Chest. 1985;85:152S–160S (Suppl)
  22. Togwood J, Jennings B, Baskerville J, Lefcoe N, Newhouse M. Assessment of a device for reducing oropharyngeal complications of beclomethasone aerosol therapy [Abstract]. Am Rev Respir Dis. 1981;123:113; (suppl)
  23. Croft RD. Two year old asthmatics can learn to operate a tube spacer by copying their mothers. Arch Dis Child. 1989;64:742–743
  24. Conner WT, Dolovich MB, Frame RA, Newhouse MT. Reliable salbutamol administration in 6- to 36-month-old children by means of a metered dose inhaler and Aerochamber with mask. Pediatr Pulmonol. 1989;6:263–267
  25. O'Callaghan C, Milner AD, Swarbrick A. Spacer device with face mask attachment for giving bronchodilators to infants with asthma. BMJ. 1989;298:160–161
  26. Appel D. Faulty use of canister nebulizers for asthma. J Family Pract. 1982;14:1135–1139
  27. De Blaquiere P, Christensen DB, Carter WB, Martin TR. Use and misuse of metered-dose inhalers by patients with chronic lung disease: a controlled, randomized trial of two instruction methods. Am Rev Respir Dis. 1989;140:910–916
  28. Epstein SW, Manning CPR, Ashley MJ, Corey PN. Survey of the clinical use of pressurized aerosol inhalers. Can Med Assoc J. 1979;120:813–816
  29. Saunders KB. Misuse of inhaled bronchodilator agents. BMJ. 1965;1:1037–1038
  30. Lee H, Evans HE. Aerosol inhalation teaching device. J Pediatr. 1987;110:249–252
  31. Munt PW. Aerosol bronchodilators and hand-lung dyscoordination [Editorial]. Can Med Assoc J. 1979;120:781
  32. Shim C, Williams MH. The adequacy of inhalation of aerosol from canister nebulizers. Am J Med. 1980;69:891–894
  33. Smith NA, Seale JP, Shae J. Medication compliance in children with asthma. Aust Paediatr J. 1984;20:47–51
  34. Rubin DH, Bauman LJ, Lauby JL. The relationship between knowledge and reported behavior in childhood asthma. J Dev Behav Pediatr. 1989;10:307–312
  35. Interiano B, Guntupalli KK. Metered-dose inhalers: do health care providers know what to teach?. Arch Intern Med. 1993;153:81–85

PII: 0091-6749(94)90173-2

The Journal of Allergy and Clinical Immunology
Volume 94, Issue 4 , Pages 669-675 , October 1994