Knowledge and practice of metered dose inhaler techniques among pediatric healthcare providers in Addis Ababa: A Cross-Sectional Study

Abstract

Background: Aerosol therapy is a cornerstone for managing childhood respiratory conditions like asthma. Inhaled medications can be given via metered-dose inhalers (MDIs), dry powder inhalers (DPIs), or nebulizers. However, there is limited information on how well pediatric providers in Ethiopia understand and perform MDI techniques. This study evaluated the knowledge and practical skills related to MDI inhaler techniques among pediatric providers at a tertiary hospital in Addis Ababa .

Methods: A hospital-based cross-sectional study was conducted among 143 pediatric healthcare providers working in the Department of Pediatrics at St. Paul's Hospital Millennium Medical College. A census sampling method was used to include all eligible providers during the study period (April to August 2021). Knowledge was assessed by structured questionnaire and practice by the IDAT tool. Bivariate and multivariable logistic regressions were performed using SPSS version 26. A p-value < 0.05 was considered statistically significant .

Results: A total of 143 pediatric healthcare providers participated (93.7% aged 24–34 years; 57.3% female). Most (48%) were pediatric residents. Only 57% had good knowledge of MDI administration techniques, and the majority (66.4%) demonstrated poor practical inhaler technique (mean practice score 3.08, SD 0.34). The most common errors were failure to hold breath after inhalation (54%), improper inhalation for the device (29%), and not waiting 30–60 seconds before the next dose (25%). On univariable analysis, residents performed better than nurses and interns in knowledge (P=0.01, COR 0.21 (0.07, 0.69)  and  practice  (p = 0.001;  COR = 6.54; 95% CI: 2.18–20.10). However, no independent predictors were identified after adjustment probably due to limited sample size and limited model power.

Conclusion: Pediatric healthcare providers had low knowledge and practice of MDI administration in children which may result in teaching incorrect MDI techniques to patients. Hence, regular training on inhalation techniques is needed for all pediatric providers.