Assessing and addressing barriers towards MDI use in acute asthma exacerbations at a tertiary pediatric ED in the United Arab Emirates.

Autor:	Sakrani NF; General Pediatrics, Division of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Hussein SE; General Pediatrics, Division of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Borg M; Pediatric Emergency Medicine, Department of Emergency Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Konstantinopoulou S; Pulmonary Medicine, Division of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Jazyk:	angličtina
Zdroj:	International journal of pediatrics & adolescent medicine [Int J Pediatr Adolesc Med] 2022 Mar; Vol. 9 (1), pp. 41-45. Date of Electronic Publication: 2021 Mar 25.
DOI:	10.1016/j.ijpam.2021.03.004
Abstrakt:	Asthma is one of the most common causes of emergency department (ED) visits in children. Therapy delivered through a meter dose inhaler with spacer (MDI + S) is equally as effective as nebulization in mild and moderate asthma exacerbations but was not routinely prescribed in the ED at the largest tertiary center for pediatrics in the United Arab Emirates (UAE). Phase 1 of this cohort study involved a validated survey to evaluate physicians' knowledge, attitudes and perceptions towards MDI therapy. While 62% of physicians reported that MDI + S was equally effective as nebulizers and 82% believed that they had sufficient knowledge with regard to its use, only 28% prescribed it. Perceived barriers to change of practice included: Lack of clinical practice guidelines (CPG), poor knowledge amongst nurses and physicians, caregivers' reluctance and a difficult prescription process. Phase 2 consisted of administering the same survey after completing interventions to address the aforementioned barriers. Comparisons were made between the subgroups within phase 1 and statistically significant differences were noted with a p value < .05. The number of physicians who prescribed MDI + S increased from 28% to 41% (p value = .046). Moreover, physicians who believed that convincing parents to use MDI + S therapy would be easy, increased from 35% to 66% (p value < .0001). In conclusion, more physicians reported prescribing MDI + S in Phase 2 while concerns about barriers that exist to change in practice remained similar in both phases showing that consistent and prolonged advocacy is required to achieve long-term compliance. Competing Interests: None. (© 2022 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)
Databáze:	MEDLINE
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