HealthDay News — Proper metered-dose inhaler (MDI)-spacer technique is lacking among the caregivers of urban minority children with persistent asthma.

Only one of 169 caregivers surveyed could complete all 10 steps on a MDI-spacer technique checklist, Marina Reznik, MD, from the Albert Einstein College of Medicine in Montefiore, New York, and colleagues reported in the Journal of Asthma.

The caregivers who completed the survey were responsible for urban minority children aged 2 to 9 years who had persistent asthma, and the 10-step checklist used to assess MDI-spacer device technique were derived from the national guidelines, literature and manufacturers’ instructions.

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Caregivers were categorized as “correct users,” defined as completing seven or more steps accurately, or “incorrect users,” defined as six or fewer steps demonstrated accurately.

The majority of the caregivers (95%) were mothers (mean age, 32.3 years; 56% unemployed); 74% of the children were Hispanic.

Overall, 87% of children had either “not well controlled” or “very poorly controlled” asthma; 92% had a spacer at home, with 71% using it “all” or “most” of the time. Correct MDI-spacer technique was independently predicted by a child having one or more asthma-related hospitalizations in the past 12 months and higher caregiver educational level, the researchers found.

“The caregivers of urban, minority children with persistent asthma lack proper MDI-spacer technique, suggesting the potential value of both targeted short- and long-term educational interventions,” the researchers concluded.


  1. Reznik M et al. J Asthma. 2013; doi: 10.3109/02770903.2013.854379.