One of the most important reasons for poor treatment is poor understanding and poor techniques of administration of drugs.
Dr. Anil Kumar Sapare has observed a trend among the children in the past six months of his tenure at Narayana Hrudayalaya that most of the children are not appropriately trained to use the drugs, inhalers, and devices.
Several observations made by Dr. Sapare are as follows:
- A lot of children take a deep breath and stop
- Other children pump the inhaler medicine to the spacer and immediately withdraw the spacer from the mouth
- Other few, were trying to breathe out into the spacer device rather than taking into the lungs
Science and Art of Drug delivering in children suffering from Asthma
Science:
The modern devices have improved the delivery of inhaled asthma medications into the lungs by using a spacer device. If it is inhaled appropriately the percentage of drug delivery into the smaller airway multiplies. However, if the spacer is not used properly, the drug delivery is misused.
Art of Administration:
It’s extremely important both the physician and parents take into consideration the age of the child and the severity of the problem. Therefore, the devices and the technique should be tailor-made. It is this point which re-emphasized that the art of administration of medication to parents and children. It is important to have an educator in a clinic who sits with a family to explain how to administer the drug and re-emphasizes the science and art of the drug to the family and children.
The care does not end here. By doing this Dr. Sapare has noted that during drug follow-up, 50% of children are taking the medications in a wrong way and use wrong techniques. Therefore, Dr. Sapare believes that after educating the child and family; the doctor needs to re-access their understanding of drug delivery. During each visit, it is important to access the technique. Other means of understanding are showing the video and booklets about inhaler devices which has remarkably helped parents and children in using the device.
Dr. Anil Kumar Sapare, Consultant Pediatric Pulmonologist, Mazumdar Shaw Medical Center, Bommasandra, Bangalore