Efficacy of a newly developed cartoon video on dry powder inhaler technique: a multicenter study

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 (V1 pre and V1 post), at one-month (V2 post), at three-month (V3 post) after watching the video and at 5-month follow-up without watching the video (V4 pre). 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 V1 pre, V1 post, V2 post and V3 post 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 V1 pre, V1 post, V2 post and V3 post were 8.6, 10.4, 11.2 and 11.4 out of 12 respectively. At the five-month follow-up, without watching video, the V4 pre 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.