Background Asthma and virus-induced wheezing are among the most common diseases in childhood, with the special problem that the response to treatment relies heavily on the correct use of the inhalation device to deliver the drug. However correct delivery of inhaled drugs is difficult for the majority of caregivers and patients, particularly for pressurised metered dose inhalers (pMDI) with spacer. Clinical inhalation situations recorded by video in conjunction with the use of a point-to-point checklist of correct inhalation technique could help to train caregivers and patients.
Purpose The aim of the study was to test the reliability and validity of a video of inhalation technique in the clinical setting using a 10-step checklist.
Material and methods Three experts in paediatric pulmonology (clinical nurse, clinical pharmacist and respiratory consultant), and one new observer scored 40 videoed inhalation sessions using pMDIs with spacer to assess inter- and intra-observer reliability. Intra-observer reliability was assessed for each observer after 1 month by scoring the inhalation demonstrations a second time. Both inter- and intra-observer reliability were expressed by mean Kappa scores.
Results All individual steps revealed a high mean percentage agreement and a substantial or almost perfect Kappa scoring for both inter- and intra-observer reliability. The 10-step checklist was precise enough to allow a new observer to evaluate the videotaped demonstrations by herself.
Conclusion The use of a videotaped recording plus a 10-step checklist represents a reliable and reproducible method for the evaluation of inhalation techniques in a clinical setting. It also represents an educational opportunity.
References and/or Acknowledgements No conflict of interest.
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