Improving inhaler technique and adherence in children

Inhalers are the mainstay of treatment for patients with asthma – but just like in adult care, inhaler technique in children is generally poor (Gillette et al, 2016; National Institute for Health and Care Excellence (NICE), 2021).

First-line treatment is to prescribe a short-acting beta 2-agonist (SABA) as a reliever therapy with newly diagnosed asthma (NICE, 2021). A low dose of an inhaled corticosteroid (IHCS) is recommended as the first-line maintenance therapy for children who are symptomatic (NICE, 2021). Despite this, many children are unable to use their inhaler devices effectively and Child (2002) suggests that many have been prescribed devices they cannot use. Some have recently had their devices changed to comply with the NHS Green Plan, swapping their medication to dry powder devices that are hydrofluorocarbon (HFC) free.

There are also many different devices, which can be confusing for patients and the health professionals who prescribe them (Alismail et al, 2016). Each inhaler device has its own set of unique characteristics relating to holding the device, its design and inhalation technology, as well as its specific advantages and disadvantages. One device may have a counter, allowing the patients to see how much medication is left in the canister, and others may not.