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Aim of study:  This research study aims to compare between two different counseling approaches; traditional verbal counseling vs. advanced counseling (in which we used the acoustic Flo-tone training device and its smartphone application combined with traditional verbal counseling) to determine the most beneficial counseling approach for asthmatic children who use metered-dose inhaler (MDI) with spacers concerning inhalation duration and inhalation technique mistakes.  Methods:  A total of 100 asthmatic children (8-18) years old were randomized into two groups (a control group, and an advanced group). Each group included 50 subjects. Every subject received 3 counseling meetings, one each month. Asthmatic children in the control group were trained on inhalation technique from MDI + spacer verbally (traditional counseling), while asthmatic children in advanced group were trained on inhalation technique from MDI + spacer verbally and by advanced counseling (whistling Flo-tone + smartphone application). At each visit mistakes in inhalation technique steps were; detected, corrected, and recorded and the inhalation duration was measured for every child in each group.  Results:  In both study groups, the total mean number of inhalation technique mistakes decreased significantly (p &lt; 0.05) from visit 2, also the total mean inhalation durations in seconds showed a significant increase (p &lt; 0.05) from visit 2. A significant (p &lt; 0.05) reduction in the total mean number of mistakes and a significant (p &lt; 0.05) increase in total mean inhalation durations were observed from visit 2 in advanced group compared to control group.  Conclusion:  Combination between traditional verbal and advanced counseling methods resulted in significant (P &lt; 0.05) improvements in the number of inhalation technique mistakes and inhalation durations from MDI with spacer in children compared to using traditional verbal counseling alone.

experimental lung research

Effect of using acoustic flo-tone training device and its smartphone application on enhancing inhalation technique from metered-dose inhaler with spacer in asthmatic children