Chaney et al

• Background to study:

  • Low rates of medical compliance a current issue in the healthcare system resulting in increased hospital admissions and mortality rates.
  • Particularly relevant in asthmatics.
  • Rates of compliance for offering medication regularly to asthmatic children range from 30% to 70%.
  • Chaney et al, 2004, found adherence does not necessarily improve with rising severity of illness.
  • Difficult to master the breathing technique to inhale the correctamount of medication.
• Aim: To test whether an asthma spacer device (a ‘Funhaler’) could provide positive reinforcement to improve adherence in child asthmatics compared to devices currently used.
• Sample: 32 children (22 male, 10 female; age range 1.5-6 years, mean age 3.2 years; av. duration of asthma 2.2 years
• IV: whether a inhaler or a funhaler was used
• DV: level of medical adherence
• Research design:

  field experiment

  repeated measures design
• Method:

  a comparison was made between the aerosol output of the small volume spacer device (235ml Breath-a-Tech) and the 225ml Funhaler Participants were interviewed with a questionnaire and parents interviewed before and after relating to ease of device, compliance of parents and children & treatment attitudes. Then they were give the Funhaler for two weeks and reported over the phone
• Funhaler


  Associated with improved parental and child compliance
• 81% (22/27) of children using the Funhaler were found to have been medicated the previous day compared to 59% of children (16/27) using the existing small volume spacer device
• Conclusion:

  Improved adherence, combined with satisfactory delivery

  characteristics, suggest that the Funhaler may be useful for

  management of young asthmatics.

  The use of the Funaler could possibly be translated to improved

  measures of clinical outcome.

  The use of functional incentive devices such as the Funhaler

  may improve the health of children.

  More research is recommended in the long-term efficacy of this

  treatment.
• 30% more children took the recommended four or more cycles per aerosol delivery (24/30 – 80% versus 15/30) when using the Funhaler compared with the standard/small volume spacer
• When using the standard/small volume spacer only 3/30 parents reported being always successful in medicating their children compared to 22/30 when using the Funhaler
• Of the parents who were unsuccessful with the conventional spacer, 17 became successful with time and practice in medicating their children, leaving 11 who never succeeded
• When these 11 were changed to the Funhaler, 7 were immediately successful
• Use of the Funhaler

  Associated with fewer problems than when using the existing device