(1041) A Non-inferiority Study to Compare Breath-actuated Inhaler Technique by Using Instructional Videos as an Educational Method

Objectives: The primary objective was to demonstrate non-inferiority of a novel breath-actuated inhaler instructional video’s ability to teach children correct inhaler technique as compared to the manufacturer’s videos for ProAir RespiClick and Qvar RediHaler. The secondary objective was to determine children’s preferences among the video instructional material.

Previous studies have shown that 87% of patients make at least one inhalation technique error and that 75% are overconfident in their technique. Incorrect inhaler technique decreases how well the medication works and patients' asthma may worsen. It is essential to design and assess the favorable methods to educate the pediatric asthma population on the correct use of their inhaler devices to ensure positive health outcomes. Different effective approaches to medication education have been studied and one approach is the use of videos to explain the correct technique to children. Most prior research videos and literature available focus on how to use metered dose inhalers. However, little evidence exists regarding the education about breath-actuated inhalers. Also, videos available from the manufacturers differ in the information provided on inhaler technique. For that reason and to make a more universal video that could be used for the education of any patient using a breath-actuated device, the researchers created a novel video. This video provides a simplified and concise format with relevant information that is easy for children to understand.

Methods: In this prospective, convenience sample study, participants 5 to 11 years old were randomized 1:1:1 to watch one of 3 instructional videos -- the novel video, ProAir Respiclick, or Qvar RediHaler. After watching the first video, participants were asked to demonstrate how to use a placebo breath-actuated inhaler and were scored by a blinded researcher using the Breath-Actuated Device Assessment Tool. After the evaluation, participants were asked questions from the Video Preference Feedback survey, and their responses were documented in Qualtrics. Participants watched the remaining 2 videos and were asked questions from the Video Preference Feedback survey for each additional instructional video. After watching the 3 videos, the participants and their caregivers were asked to complete an optional demographics survey.

The sample size (each group = 37, a total of 111) provided 80% power using a one-sided test at the 0.025 significance level. A two-sample t-test for the noninferiority was performed to evaluate whether the efficacy of the study video was not significantly worse than that of the 2 manufacturer videos. For the video preference, the overall p-value for equality of proportions of the 3 videos was computed using the proportion test.

Results: N/A

Conclusions: N/A