Abstract
The National Asthma Education and Prevention Program recommends that providers demonstrate and assess metered-dose inhaler-spacer (MDI-S) technique at each medical visit. To examine practice behaviors and perceived barriers to demonstrating and assessing MDI-S technique, we surveyed pediatric providers (n = 114) at an inner-city academic medical center. While 82% of providers demonstrated MDI-S technique, only 5% of providers demonstrate the technique at every visit. Although 67% of providers assessed MDI-S technique, only 13% assess the technique at every visit. None of the providers used MDI-S checklist for assessment. Attendings were more likely than residents to demonstrate with illustrations (24% vs 6%, P = .01) and when patient's asthma was not well controlled (68% vs 47%, P = .05). Provider-identified barriers included limited access to MDI-S device, lack of time, and inadequate knowledge. Suggestions to address barriers include in-service training, device access, and nurse/health educators to alleviate the time constraints. Clinic modifications and education are needed.
References
Jul 22, 1998·Respiration; International Review of Thoracic Diseases·V Plaza, J Sanchis
Feb 28, 2002·The European Respiratory Journal·V Giraud, N Roche
Sep 30, 2005·American Journal of Respiratory and Critical Care Medicine·Omar S UsmaniPeter J Barnes
Oct 26, 2005·Annals of Epidemiology·Luz ClaudioJames Godbold
Mar 23, 2006·Journal of Aerosol Medicine : the Official Journal of the International Society for Aerosols in Medicine·Sunalene G Devadason
May 17, 2006·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Kelechi IheagwaraPhilip O Ozuah
Oct 10, 2007·Respiratory Medicine·J C VirchowP J Barnes
Feb 19, 2008·Thorax·M R PartridgeM Campbell
Nov 13, 2008·The Journal of School Health·Sheryl MagzamenIra B Tager
Nov 6, 2009·American Journal of Public Health·Tyra Bryant-StephensHauqing Zhao
Jun 10, 2010·Archives of Pediatrics & Adolescent Medicine·Paula LozanoGail M Kieckhefer
Mar 4, 2011·Respiratory Medicine·Andrea S MelaniUNKNOWN Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri
Mar 30, 2011·Pediatrics·Betsy SleathDeidre Washington
May 24, 2011·Patient Education and Counseling·Deidre WashingtonGail Tudor
Nov 8, 2011·Journal of Pediatric Nursing·Marilynne R Wood, Dawn Bolyard
Sep 15, 2012·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Betsy SleathChris Gillette
Sep 18, 2013·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Mark L LevyJohn Holmes
Oct 18, 2013·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Marina ReznikYu Cao
Citations
Sep 15, 2015·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Dayna S AlexanderDelesha M Carpenter
Sep 17, 2014·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Wesam G AmmariHenry Chrystyn
Apr 21, 2020·Expert Review of Respiratory Medicine·Anna VolermanValerie Press
Jun 1, 2016·The Canadian Journal of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmières·Mahmoud Al-KalaldehAmal El-Ata
Jul 14, 2020·Frontiers in Pediatrics·Robert W MortonLesley Kennedy
Nov 6, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Jennifer A JonasMarina Reznik