Abstract and Introduction


Background: Asthma medications should be used correctly to be effective. Incorrect pressurized metered dose inhaler valved holding chamber (pMDI-VHC) technique results in inadequate asthma control.

Problem: Reports indicate nearly 80% of individuals with asthma do not use inhalers correctly, and 67% of providers who care for individuals with asthma cannot demonstrate correct device technique.

Methods and Interventions: This quality improvement project was initiated to improve child asthma control by teaching correct pMDI-VHC technique. Prior to initiating the project, the providers engaged in a brief educational session regarding the six-step technique for proper pMDI-VHC use to promote consistent education of participants. A pre/post project design was used to assess the effect of a six-step educational/skill-building intervention. Children age 7 to 11 years with persistent asthma and able to perform Pulmonary Function Testing (PFT) and pMDI-VHC technique (N = 35) were included. The Childhood Asthma Control Test (C-ACT) and the Mini Pediatric Asthma Quality of Life Questionnaire (MiniPAQLQ) assessed the child’s asthma control and quality of life at three time points (T1, T2, T3). PFTs were completed at baseline and T3 to appreciate the effects of the intervention on lung function.

Results: We identified statistically significant improvement in child asthma control and quality of life outcomes (C-ACT p = 0.000 and MiniPAQLQ p = 0.004) and a small effect on pulmonary function (pre-FEV1 d = 0.124; pre-FEF25–75 d = 0.040).

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Conclusion: Participants demonstrated significant improvement in recall of correct pMDI-VHC steps and technique at each successive project time point, and self-reported asthma control also improved. Children and their parents who are taught this method of proper inhaler use in primary clinical settings may experience similar improvements in child asthma control as observed in this project.

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