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

Main Article Content

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

Keywords

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

Abstract

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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References

1. Aït-Khaled N, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J. ISAAC Phase Three Study Group. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Allergy. 2009;64:123-48.

2. Porsbjerg C, Menzies-Gow A. Co-morbidities in severe asthma: clinical impact and management. Respirology. 2017;22:651-61.

3. Benninger MS, Hadley JA, Osguthorpe JD, Marple BF, Leopold DA, Derebery MJ, et al. Techniques of intranasal steroid use. Otolaryngol Head Neck Surg. 2004;130:5-24.

4. Rollema C, Van Roon EN, De Vries TW. Inadequate quality of administration of intranasal corticosteroid sprays. J Asthma Allergy. 2019;12:91-4.

5. Braido F, Chrystyn H, Baiardini I, Bosnic-Anticevich S, van der Molen T, Dandurand RJ, et al. Trying, ¨ But Failing¨- the role of inhaler technique and mode of delivery in respiratory medication adherence. J Allergy Clin Immunol Pract. 2016;4:823-32.

6. Rollema C, van Roon EM, Schilder AG, de Vries TW. Evaluation of instructions in patient information leaflets for the use of intranasal corticosteroid sprays: an observational study. BMJ Open. 2019;15:e026710.

7. Indradat S, Jirapongsananurak O, Visitsunthorn N. Evaluation of animated cartoon-aided teaching of intranasal corticosteroid administration technique among Thai children with allergic rhinitis. Asian Pac J Allergy Immunol. 2013;32:166-70.

8. Arumugom A, Chandrasekaran V. A randomized comparison between video demonstration and verbal instruction in improving rota haler technique in children with persistent asthma: a pilot study. J Clin Diagn Res. 2017;11:SC05-07.

9. Shaw N, Le Souëf P, Turkovic L, McCahon L, Kicic A, Sly PD, et al. Pressurised metered-dose inhaler-spacer technique in young children improves with video instruction. Eur J Pediatr. 2016;175:1007-12.

10. Shah RF, Gupta RM. Video instruction is more effective than written instruction in improving inhaler technique. Pulm Pharmacol Ther. 2017;46:16-9.