In the first study to evaluate inhaler technique in children hospitalized for asthma—the group at highest risk for complications and death from asthma —researchers found that nearly half of participants demonstrated improper inhaler use, which means they routinely were not taking in the full dose of medication.

Adolescents most commonly displayed critical errors in inhaler technique. They also often skipped using a spacer, which is a device that is recommended for use with an inhaler to help the right amount of asthma medication reach the lungs. Findings were published in the Journal of Hospital Medicine.

“We know that asthma can be well managed in the majority of patients and using your inhaler correctly is key factor to managing asthma,” says lead author Waheeda Samady, MD, hospitalist at Ann & Robert H. Lurie Children’s Hospital of Chicago, and assistant professor of pediatrics at Northwestern University Feinberg School of Medicine. “Improper inhaler technique can contribute to children having uncontrolled asthma and needing to come to the hospital for their asthma. Our study suggests that, as health-care providers, we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it.”

Out of 113 study participants, 2–16 years of age, 42% missed at least one critical step in their inhaler technique. Researchers found that 18% did not use a spacer device with their inhaler, and that these patients were mostly older.

“We see that our adolescent patients, who are transitioning to independent medication management, still need close monitoring to make sure they use their inhaler and spacer appropriately to achieve optimal asthma control,” says Dr. Samady. “Teens may feel that using a spacer is only for younger children, but using a spacer is recommended for adults as well.”

Previous studies have shown that adding a spacer device to an inhaler increases the amount of asthma medication a person takes in from 34% to 83%. “Children with asthma can lead full lives if they receive the right medication at the appropriate dose, which is why correct inhaler technique is so crucial,” says Dr. Samady.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine, and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by US News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 212,000 children from 49 states and 51 countries.