A Comparative Study on the Effect of Incentive Spacer and Ordinary spacer on the correct use of the inhaler and Symptom Control in Children with Asthma

Abstract

Abstract: Introduction and Objective: Asthma is the most common and costly chronic inflammatory airway disease and the most common chronic disease in childhood. Environmental controls and drug are two main aspects of asthma management. Among all medications, inhalation drugs are the appropriate way of managing asthma. These medications are the first and basic treatments of asthma. Various studies show that the incorrect use of inhaler is one of the main factors of failure in disease control. Since more than 80% of asthmatic patients, especially children, cannot take inhalation drugs properly, this study aimed to compare the effects of inventive incentive and regular inhaler on the correct use of inhalation spray and controlling symptoms in asthmatic children. Materials and Methods: In this clinical trial, 40 adolescents and 60 children with moderate stable asthma who had asthma for the first time were selected by non-probability easy sampling. Then, the subjects were randomly divided into two groups of control (A) and intervention (B). During the research process, the correct method of using steroid inhalation spray was evaluated 3 times (pretest, primary post-test and secondary post-test) by checklist and asthma control score with C-ACT in the child's age and ACT in adolescents was evaluated two times (pre-test, post-test) with a month interval. Finally, data of 100 samples were analyzed by SPSS software version 16. Results: Mann-Whitney test in 6-11 children and 12-18-year-old adolescents’ participants showed that there was no significant difference between the mean score of correct use of inhalation spray in incentive and regular inhalers groups before the intervention (P=0.267 in children) and (P=0.847 in adolescents). Immediately after the intervention, the mean score difference between the two groups was statistically significant in 6-11-year-old children (p=0.025) and insignificant in 12-18-year-old adolescents (p=0.486). One month after the intervention in children and adolescents, the mean score of correct use of inhalation spray was significantly different between the two groups (P<0.001 in the children and P=0.001 in adolescents). The mean of asthma control score change in children, before and after the intervention, was calculated higher in incentive inhaler group (13.2±2.3) in comparison with regular inhaler group (11.4±2.3) and the results of independent t-test indicated that this difference was significant at 95% confidence level (P=0.004). The mean change in asthma control score in adolescents, before and after the intervention, in incentive inhaler group was calculated higher (12.6±1.7) in comparison with regular inhaler group (11.8±2.3) and the results of Mann-Whitney test indicated that this difference was significant at 95% confidence level (P<0.001). Conclusion: Incentive inhaler in comparison with regular inhaler increased the correct use of inhalation spray in 6-11 and 12-18-year-old asthmatic subjects and on the other hand, it was effective on asthma control score in children and adolescents. Therefore, it is recommended to use incentive inhaler to receive inhalation medications.