Errors during inhaler use in pediatric asthma: an integrative review
DOI:
https://doi.org/10.61411/rsc202475917Palavras-chave:
Asma, técnica inalatória, aerossóis dosimetrados, erros, Crianças, adolescentesResumo
In Brazil, asthma has a prevalence of 20% among pediatric patients. Inhaler therapy is paramount in asthma treatment, with multiple devices and drugs available. One of the main factors for uncontrolled asthma is the incorrect use of inhalers. The study aimed to review the literature of the last 20 years to identify the most common errors in the use of metered-dosed inhalers by pediatric patients and to propose strategies to mitigate those errors. The term “inhaler” was combined with “technique”, “asthma,” and “errors” using the operator “AND” in multiple databases. After screening for inclusion and exclusion criteria, 12 studies were selected from databases. Six more studies were found after hand searching the references of the selected studies. The predominant errors for inhaler use were failure to wait around one minute before additional doses and fast and incomplete exhales before using the device. Less common errors encompassed triggering the device more than once, lack of coordination between device triggering and inhalation, and improper sealing of the mask or mouth when using an inhaler with a spacer. Incorrect inhaler use among pediatric patients hinder the success of the asthma treatment and decrease the medication efficacy. The adoption of strategies to avoid the errors identified by this review may contribute to better quality of care for this population.
Referências
World Health Organization. Asthma [Internet- key facts]. [acesso 05 fev 2024]. Disponível em: https://www.who.int/news-room/fact-sheets/detail/asthma
Shin YH, Hwang J, Kwon R, Lee SW, Kim MS; GBD 2019 Allergic Disorders Collaborators; Shin JI, Yon DK. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy. 2023
Aug;78(8):2232-2254. doi: 10.1111/all.15807. Epub 2023 Jul 11. PMID: 37431853; PMCID: PMC10529296.
IV Diretizes Brasileiras para o Manejo da Asma. J bras pneumol. novembro de 2006;32(suppl 7):S447–74.
Maricoto T, Madanelo S, Rodrigues L, Teixeira G, Valente C, Andrade L, et al. Educational interventions to improve inhaler techniques and their impact on asthma and COPD control: a pilot effectiveness-implementation trial. J bras pneumol. dezembro de 2016;42(6):440–3.
Oliveira PD de, Menezes AMB, Bertoldi AD, Wehrmeister FC, Macedo SEC. Avaliação da técnica de utilização de dispositivos inalatórios no tratamento de doenças respiratórias no sul do Brasil: estudo de base populacional. 2014;40(5):513–20.
Souza LS de F. Aerosol therapy in childhood asthma. J Pediatr (Rio J). 15 de maio de 1998;74(3):189–204.
Usmani OS, Lavorini F, Marshall J, Dunlop WCN, Heron L, Farrington E, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. dezembro de 2018;19(1):10.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2024. Updated May 2024. Available from: www.ginasthma.org
Iniciativa Global para a Doença Pulmonar Obstrutiva Crónica. Revista Portuguesa de Pneumologia. novembro de 2001;7(6):621–4.
Soilemezi D, Linceviciute S. Synthesizing Qualitative Research: Reflections and Lessons Learnt by Two New Reviewers. International Journal of Qualitative Methods. 1º de dezembro de 2018;17(1):160940691876801.
Burkhart PV, Rayens MK, Bowman RK. An evaluation of children’s metered-dose inhaler technique for asthma medications. Nurs Clin North Am. março de 2005;40(1):167–82.
Alexander DS, Geryk L, Arrindell C, DeWalt DA, Weaver MA, Sleath B, et al. Are children with asthma overconfident that they are using their inhalers correctly? J Asthma. 2016;53(1):107–12.
Wanda Hagmolen of ten Have, van de Berg, N. J., Bindels, P. J. E., van Aalderen, W. M. C., & van der Palen, J. (2008). Assessment of Inhalation Technique in Children in General Practice: Increased Risk of Incorrect Performance with New Device. Journal of Asthma, 45(1), 67–71.
Adnan M, Karim S, Khan S, Al-Wabel NA. Comparative evaluation of metered-dose inhaler technique demonstration among community pharmacists in Al Qassim and Al-Ahsa region, Saudi-Arabia. Saudi Pharm J. abril de 2015;23(2):138–42.
Samady W, Rodriguez VA, Gupta R, Palac H, Karamanis M, Press VG. Critical Errors in Inhaler Technique among Children Hospitalized with Asthma. J Hosp Med. 1º de junho de 2019;14(6):361–5.
Pecoraro L, Norato A, Accorsi P, Dalle Carbonare L, Piacentini G, Pietrobelli A. Inhalation technique in asthma in children: could an intensive summer educational camp improve it? Acta Biomed. 19 de janeiro de 2022;92(6):e2021400.
Spaggiari S, Gehri M, Di Benedetto L, Hafen GM, Pauchard JY, Gervaix A, et al. Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings. J Asthma. fevereiro de 2021;58(2):190–6.
Almomani BA, Al-Qawasmeh BS, Al-Shatnawi SF, Awad S, Alzoubi SA. Predictors of proper inhaler technique and asthma control in pediatric patients with asthma. Pediatr Pulmonol. maio de 2021;56(5):866–74.
Manríquez P, Acuña AM, Muñoz L, Reyes A. Study of inhaler technique in asthma patients: differences between pediatric and adult patients. J Bras Pneumol. 2015;41(5):405–9.
Sleath B, Ayala GX, Gillette C, Williams D, Davis S, Tudor G, et al. Provider demonstration and assessment of child device technique during pediatric asthma visits. Pediatrics. abril de 2011;127(4):642–8.
Reznik M, Silver EJ, Cao Y. Evaluation of MDI-spacer utilization and technique in caregivers of urban minority children with persistent asthma. J Asthma. março de 2014;51(2):149–54.
Iheagwara K, Sharif I, Ozuah PO. Do pediatric healthcare providers know how to use metered dose inhaler plus spacer devices? Primary Care Respiratory Journal. 1º de junho de 2005;14(3):172–3.
Owayed A, Al-Ateeqi W, Behbehani N. Proficiency of Pediatricians in the Use of Inhaled Medication Delivery Systems for the Management of Asthma. Journal of Asthma. janeiro de 2006;43(6):459–62.
Deerojanawong J, Promsaka na Sakolnakorn V, Prapphal N, Hanrutakorn C, Sritippayawan S. Evaluation of metered-dose inhaler administration technique among asthmatic children and their caregivers in Thailand. Asian Pac J Allergy Immunol. 2009;27(2–3):87–93.
Usmani OS, Lavorini F, Marshall J, Dunlop WCN, Heron L, Farrington E, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. dezembro de 2018;19(1):10.
Sleath B, Ayala GX, Gillette C, Williams D, Davis S, Tudor G, et al. Provider demonstration and assessment of child device technique during pediatric asthma visits. Pediatrics. abril de 2011;127(4):642–8.
Vincken W, Levy ML, Scullion J, Usmani OS, Dekhuijzen PNR, Corrigan CJ. Spacer devices for inhaled therapy: why use them, and how? ERJ Open Res. Abril de 2018;4(2):00065–2018.
Newman SP. Spacer Devices for Metered Dose Inhalers: Clinical Pharmacokinetics. 2004;43(6):349–60.
Plaza V, Giner J, Rodrigo GJ, Dolovich MB, Sanchis J. Errors in the Use of Inhalers by Health Care Professionals: A Systematic Review. J Allergy Clin Immunol Pract. 2018;6(3):987–95.
Terzano C. Metered dose inhalers and spacer devices. Eur Rev Med Pharmacol Sci. 1999;3(4):159–69.
Publicado
Licença
Copyright (c) 2024 Revista Sociedade Científica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Para saber mais: Termos da Licença e Direitos Autorais - Revista Sociedade Científica
