Smart Inhaler Randomized Controlled Trial for Improving Inhaler Technique in Adolescents With Intellectual and Developmental Disabilities and Asthma

IF 2.8 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2026-09-01 Epub Date: 2026-07-07 DOI:10.1016/j.acap.2026.103387

Sophia Park MD, Alexis Deavenport-Saman DrPH, MPH, My H. Vu MS, Ramon Durazo-Arvizu PhD, Hyunbin Park MD, Jeanne Delgado MD, MPH, Christine B. Mirzaian MD, MPH, IBCLC, Caitlin Sayegh PhD, Naydelli Mendoza MPH, Jasmine Osumo MPH, PTA, CBIS, Megan Enciso MPH, Aneli Torres MPH, Larry Yin MD, MSPH

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引用次数: 0

Abstract

Objective

To evaluate the feasibility, acceptability, and usability of a real-time feedback smart inhaler for adolescents with intellectual and developmental disabilities (IDD) and asthma; assess preliminary efficacy in improving metered-dose inhaler (MDI) technique; and explore device-measured proficiency and lung function in the full cohort, alongside a predefined autism subgroup analysis.

Methods

We conducted a single-center, single-blind, pilot randomized controlled trial involving 28 adolescents (aged 10–17 years) with IDD and asthma. Participants were randomized 1:1 to an intervention group using smart inhalers with audiovisual feedback for 8 weeks, or a control group receiving standard asthma education. Primary outcomes were parent- and adolescent-reported feasibility, acceptability, and usability. The secondary outcome was observer-rated inhaler proficiency. Exploratory outcomes were full-cohort device-measured inhaler proficiency and lung function (FEV₁ and PEF), alongside a predefined autism subgroup analysis.

Results

The intervention was feasible, acceptable, and usable, yielding high parent and adolescent motivation and satisfaction. The intervention group demonstrated significantly greater improvement in observer-rated Inhaler Proficiency Scale scores from baseline to week 8 compared to the control group (mean difference 1.5 points; 95% CI: 0.4–2.6; P = .02). Exploratory outcomes showed no significant between-group differences in lung function or device-measured proficiency. However, the autism subgroup exhibited inhaler technique improvements consistent with the broader cohort.

Conclusions

Smart inhalers are feasible, acceptable, and usable for adolescents with IDD, and are associated with significant improvement in observer-rated inhaler technique when combined with standard clinical education. Given the inherent challenges of spirometry in this population, future studies should incorporate effort-independent clinical assessment measures.

查看原文本刊更多论文

智能吸入器改进吸入器技术在患有智力和发育障碍及哮喘的青少年中的随机对照试验。

目的：评价实时反馈智能吸入器用于青少年智力发育障碍（IDD）和哮喘患者的可行性、可接受性和可用性；评估改进计量吸入器技术的初步效果；并在整个队列中探索设备测量的熟练程度和肺功能，以及预定义的自闭症亚组分析。方法：我们进行了一项单中心、单盲、随机对照试验，纳入了28名患有IDD和哮喘的青少年（10-17岁）。参与者按1:1的比例随机分为使用智能吸入器并提供视听反馈的干预组和接受标准哮喘教育的对照组，干预组为期8周。主要结局是父母和青少年报告的可行性、可接受性和可用性。次要结果为观察者评价的吸入器熟练程度。探索性结果是全队列设备测量的吸入器熟练度和肺功能（FEV1和PEF），以及预定义的自闭症亚组分析。结果：干预是可行的、可接受的、可用的，产生了较高的家长和青少年的动机和满意度。与对照组相比，干预组在观察者评定的吸入器熟练度量表评分从基线到第8周的改善显著更大（平均差1.5分；95% CI: 0.4-2.6; p=0.02）。探索性结果显示组间肺功能或设备测量熟练程度无显著差异。然而，自闭症亚组表现出吸入器技术的改进与更广泛的队列一致。结论：智能吸入器对于患有IDD的青少年是可行的、可接受的和可用的，并且当与标准临床教育相结合时，与观察者评价的吸入器技术的显着改善相关。考虑到肺活量测定在这一人群中的固有挑战，未来的研究应纳入不依赖于努力的临床评估措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.