An age-adjusted instruction video enhances the correct use of nasal corticosteroid sprays in children

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Susanne ter Laak
Iris Lucas
Juliët Oude Nijeweeme
Lara van Ravenstein
Kim de Jong
Corine Rollema
Tjalling de Vries


Corticosteroids, Intranasal, Allergic rhinitis, Administration technique, Video instruction


Introduction and objectives: Allergic rhinitis is a common disorder. Intranasal corticosteroid sprays are used to control symptoms. However, incorrect use of these sprays can decrease efficacy and lead to side effects such as nose bleeding. We studied if watching an age-adjusted instruction video is effective to improve administration technique.

Materials and methods: We invited children who used intranasal corticosteroid sprays. We examined their administration technique before, directly after, and one month after showing them an age-adjusted instruction video. We compared their administration technique with the instructions in the patient information leaflet. We assessed whether the children performed the seventeen maneuvers mentioned in the patient information leaflet and the eight we considered essential.

Results: Of the 99 eligible children, 23 (15 boys, median age nine years) participated. Before watching the instruction video none of them administered according to all maneuvers in the patient information leaflet or showed all essential maneuvers. One month after seeing the instruction video, three children demonstrated correct inhalation as per the patient information leaflet. Three performed the essential maneuvers. When a 75% threshold level for carrying out all 17 maneuvers was used, still none showed 75% of all or of the essential maneuvers before watching the video. Yet, after one month 12 children showed sufficient administration technique (52%, 95% confidence interval (CI) 31%-73%, p = 0.004). Nine showed all essential manoeuvres (47%, 95%CI 24%-71%, p = 0.004).

Conclusions: An age-adjusted instruction video is a useful and easy method to teach children to administer nasal intranasal corticosteroid sprays correctly.

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