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Randomized Controlled Trial
. 2023 Aug;131(2):217-223.e1.
doi: 10.1016/j.anai.2023.02.023. Epub 2023 Mar 3.

Evaluating inhaler education interventions for hospitalized children with asthma: A randomized controlled trial

Anna Volerman  1 , Uma Balachandran  2 , Mengqi Zhu  2 , Mary Akel  2 , Ashley Hull  2 , Michelle Siros  2 , Viridiana Luna  2 , Isabella Xu  2 , Valerie G Press  3
Affiliations
Randomized Controlled Trial

Evaluating inhaler education interventions for hospitalized children with asthma: A randomized controlled trial

Anna Volerman et al. Ann Allergy Asthma Immunol. 2023 Aug.

Abstract

Background: Most children with asthma have poor inhaler technique, with detrimental morbidity effects. Guidelines recommend clinicians provide inhaler education at every opportunity, yet resources are limited. A low-cost, technology-based intervention-Virtual Teach-to-Goal (V-TTG)-was developed to deliver tailored inhaler technique education with high fidelity.

Objective: To evaluate whether V-TTG leads to less inhaler misuse among children with asthma who are hospitalized vs brief intervention (BI, reading steps aloud).

Methods: A single-center randomized controlled trial of V-TTG vs BI was conducted with 5-to-10-year-old children with asthma hospitalized between January 2019 and February 2020. Inhaler technique was assessed pre- and post-education using 12-step validated checklists (misuse: < 10 steps correct).

Results: Among 70 children enrolled, mean age was 7.8 years (SD = 1.6). Most (86%) were Black. Most had an emergency department visit (94%) or hospitalization (90%) in the previous year. At baseline, nearly all children misused inhalers (96%). The proportion of children with inhaler misuse decreased significantly in V-TTG (100%→74%, P = .002) and BI (92%→69%, P = .04) groups, with no difference between groups at both time points (P = .2 and .9). On average, children performed 1.5 more steps correctly (SD = 2.0), with greater improvement with V-TTG (mean [SD] = 1.7 [1.6]) vs BI (mean [SD] = 1.4 [2.3]), though not significant (P = .6). Concerning pre and post technique, older children were significantly more likely than younger children to show more correct steps (mean change = 1.9 vs 1.1, P = .002).

Conclusion: A technology-based intervention for tailored inhaler education led to improved technique among children, similarly to reading steps aloud. Older children saw greater benefits. Future studies should evaluate the V-TTG intervention across diverse populations and disease severities to identify the greatest impact.

Clinical trial registration: NCT04373499.

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Conflict of interest statement

Conflict of interest: Valerie Press has consulted for Humana and Vizient. The other authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Conceptual model of Virtual Teach-to-Goal *Videos and questions tailored based on age
Figure 2.
Figure 2.
CONSORT flow diagram
Figure 3.
Figure 3.
Percentage of children with inhaler misuse compared pre and post intervention
See this image and copyright information in PMC

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References

    1. Bloom B, Jones L, Freeman G. Summary Health Statistics for US Children: National Health Interview Survey, 2012. National Center for Health Statistics; 2013. - PubMed
    1. National Surveillance of Asthma: United States, 2001-2010. U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2012.
    1. Akinbami LJ, Simon AE, Rossen LM. Changing trends in asthma prevalence among children. Pediatrics. 2016;137(1):e20152354. doi:10.1542/peds.2015-2354 - DOI - PMC - PubMed
    1. AsthmaStats: Asthma-Related Missed School Days among Children Aged 5-17 Years.; 2015. Accessed July 15, 2022. https://www.cdc.gov/asthma/asthma_stats/missing_days.htm
    1. Centers for Disease Control and Prevention. Asthma Data, Statistics, and Surveillance. Most Recent Asthma Data. Published March 25, 2019. Accessed July 15, 2022. https://www.cdc.gov/asthma/most_recent_data.htm

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