Efficacy of a newly developed cartoon video on dry powder inhaler technique: a multicenter study
Thitima Sirimontakan,1 Wiparat Manuyakorn,1 Harutai Kamalaporn,1 Pornchai Wattanarungsun,2 Kuntalee Chonpaisan,3 Korakot Thongkum,4 Prapasiri Singvijarn,5 Sintra Phumethum6
1 Department of Pediatrics, Faculty of Medicine, Ramathibodi hospital, Mahidol University, Bangkok, Thailand
2 Department of Pediatrics, Chaophraya Yommaraj hospital, Suphanburi, Thailand
3 Department of Pediatrics, Yala hospital, Yala, Thailand
4 Department of Pediatrics, Vajira Phuket hospital, Phuket, Thailand
5 Department of Pediatrics, Charoenkrung Pracharak hospital, Bangkok, Thailand
6 Department of Pediatrics, Prapokklao hospital, Chanthaburi, Thailand
Abstract
Background: One of the factors associated with uncontrolled pediatric asthma is inadequate delivery of inhaled medication to the lungs. Incorrect inhaler technique has been reported. We developed a 2-minute cartoon video instruction aiming to improve dry powder inhaler (DPI) technique.
Objective: To assess the efficacy of video instruction in improvement of DPI technique in Thai children with asthma.
Methods: The prospective multicenter cohort study was conducted during March 2018 – February 2019. Children with asthma aged 6-15 years were recruited from the outpatient departments. Five videotapes demonstrated how the patients use DPI devices were recorded as the followings: before and after watching video (V1pre and V1post), at one-month (V2post), at three-month (V3post) after watching the video and at 5-month follow-up without watching the video (V4pre). Scoring of correct DPI steps were evaluated by two independent respiratory specialists.
Result: Of 57 patients recruited, 30 used Accuhaler™ while 27 used Easyhaler™. In Accuhaler™ group, the median age (range) of 10 (8, 11) year. The mean score of V1pre, V1post, V2post and V3post were 10.7, 12.3, 12.4, and 12.2 out of 14 respectively. In Easyhaler™ group, the median age (range) of 11 (9-12) year. The mean score of V1pre, V1post, V2post and V3post were 8.6, 10.4, 11.2 and 11.4 out of 12 respectively. At the five-month follow-up, without watching video, the V4pre score was still as high as 12.9 ± 1.3 in Accuhaler™ and 11.8 ± 0.4 in Easyhaler™.
Conclusion: Our video instruction could improve Accuhaler™ and Easyhaler™ technique among Thai children with asthma.
Key words: pediatric asthma, dry powder inhaler, inhaler techniques, video instruction, multicenter study,