Children and Families Often Don't Know When Inhalers Are Empty

By Shawana Alleyne-Morris

May 24, 2022

NEW YORK (Reuters Health) - Most children and their families don't know when their metered dose inhalers (MDIs) are empty or how to properly dispose of them, researchers found.

"The crucial disadvantage of the MDIs is the inability to identify the amount of medications left in the inhalers. This is due to the design of MDIs which contain a propellent along with the active drug to expel the labeled number of actuations," Dr. Isobel Fullwood from Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK, and colleagues point out in Archives of Diseases in Childhood.

Dr. Fullwood's team asked 157 children and their caregivers how they identify an empty salbutamol inhaler. The children had been prescribed inhalers between October 2020 and September 2021 for asthma, preschool wheeze, cystic fibrosis and bronchiectasis.

Although prescriptions include drug information and how to use the MDI, consistent information on identifying when the device is empty is lacking, the researchers say

Overall, 125 (73.5%) patients deemed an empty inhaler as either full/partially full. Only three patients used the dose counter and two kept track of each actuation. Twelve of 66 (18.2%) preventer inhalers with a dose counter were empty.

Roughly four in five participants disposed of their inhalers in a dustbin rather than returning them to the pharmacy.

The authors say regulators should mandate dose counters on all inhalers, pharmaceutical companies should improve their educational information regarding identification of empty inhalers, and healthcare providers should include identification of an empty MDI as "part of essential asthma care."

"Finally," they add, "healthcare professionals must all take responsibility for raising awareness of the safe and environmentally friendly disposal of MDIs."

SOURCE: Archives of Diseases in Childhood, online May 12, 2022.