The use of inhaled drugs in the population of Polish pediatric patients suffering from bronchial asthma

Abstract

Introduction: Inhalation drugs are the basis for both acute and chronic treatment of children with bronchial asthma. The choice of the method of aerosol therapy belongs to the physician who is responsible for the treatment and what should be considered is patient’s age together with understanding and willingness to follow orders, physical and mental capabilities, cooperation and the possibilities, skills and willingness of its guardians. To obtain a control of the disease it is necessary to provide training of the patient and his caregiver before starting the treatment and later during chronic treatment – regular control of the method of medication inhalation. It is equally important to transfer this knowledge to caregivers who will control the baby’s aerosol therapy at home. Their understanding and acceptance of a given inhalation system depends on therapeutic success. Aim of the research: This study aimed to obtain information on what methods of aerosol therapy are used in Polish pediatric patients with asthma, whether children and caregivers are using aerosol therapy techniques properly and what proportion of patients (and their guardians) has been trained by medical staff in this regard. Material and methods: Research was conducted in the form of a survey. Two versions of the questionnaire had been created (for parents of children aged 0–5 years and for children of 6 years and above). For the purpose of the study, parents and children completed the survey during the hospitalization in the Clinic of Allergology and Pneumonology of the Institute of Tuberculosis and Lung Diseases in Rabka-Zdroj from February 2016 to November 2018. One of the survey questions concerned the fact that parent or a child completed a Childhood Asthma Control Test (C-ACT) and other questions concerned the knowledge of the PEFR peak expiratory flow meter (“peak flow meter”, “pefrometer”). Results: Parents of 82 patients aged 0–5 (51 boys, 31 girls) and parents of 128 patients ≥ 6 years old (63 boys, 65 girls) took part in the survey. The data were obtained from the analysis of 210 questionnaires. The average age of diagnosis of bronchial asthma was 4 years and 7 months (younger group) and 5 years and 1 month (older group). Some of the questions were open (regarding the medicines and commercial names of inhalers and inhalation chambers), most in a closed form (single or multiple choice from several options). Over 93% of patients declared short-acting b-mimetic drugs (SABA). In the group of children aged 0–5 years, it was administered to patients on an ad hoc basis in nebulization (52.4%), and via pressure inhalers pMDI (62.2%) (several answers could be selected). In the group of children ≥ 6 years 34% of patients use SABA drugs in nebulization, 46.9% by pMDI and 18.8% by powder inhalers. In the group 0–5 years inhaled drugs in a chronic nebulization are taken by 52.4% of patients, whereas in the group of ≥ 6 years 25% take it in nebulization, 43% from the pMDI pressure inhaler, and 32% from the DPI dry powder inhaler. In the group of ≥ 6 years of age