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

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. RESULTS: 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™. CONCLUSIONS: Our video instruction could improve Accuhaler± and Easyhaler± technique among Thai children with asthma.

PARENTAL KNOWLEDGE OF THE ADVERSE EFFECTS OF HOUSEHOLD TOBACCO SMOKE EXPOSURE IN ASTHMATIC CHILDREN.

The aim of this study was to determine the prevalence of household tobacco smoke exposure in children presenting to asthma clinic at Prapokklao Hospital and to survey parental knowledge and perception to the dangers of household smoke exposure. Parents/guardians who brought their children to asthma clinic during June-September 2014 were interviewed to complete survey questionnaires. If there were smokers in the household, questionnaires with a postage paid self-addressed envelopes were given to the family to take back home for other household smokers to complete. There were 149 asthmatic children who attended the asthma clinic during the study period. Seventy-one pediatric patients (47.7%) lived with at least one household smoker. Thirty-one smokers completed the questionnaires. Only five (16.1%) accompanied the patients to asthma clinic. Almost all of the smokers had a desire to quit smoking, and 58.1% of the smokers and 63.2% of the non-smokers had received information regarding the dangers of household smoke exposure. The knowledge test scores were not different between the two groups. The prevalence of household smoke exposure in asthmatic children was high, despite most of the smokers knew about the adverse effects of household smoke exposure on their children' s health and desired to quit smoking.