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Some of the prevalent issues in asthma control include incomplete adherence, poor patient inhaler technique and incorrect device selection. Approximately 28% to 68% of patients do not use their pressurised metered-dose inhalers (pMDIs) or dry-powder inhalers (DPIs) well enough to benefit from their medication. For patients using MDIs alone, only 9% of medication is delivered to the lungs and 81% to the oropharynx.
pMDI advantages
pMDIs are small, portable and quick. They are easy to clean and more effective than most nebulisers or DPIs.
pMDI problems
The high speed of the spray is problematic spray. Actuation occurs too early or too late. Hand-breath co-ordination can be difficult and rapid inhalation inevitably follows. High inspiratory flow goes to the upper airways while lower flow results in peripheral deposition.
Spacers
Spacers create additional volume in which the medication is dispersed. This leads to an increase in lung deposition and prevents oral deposition. They are generally underused and may be costly. Low-cost alternatives are required. Spacers improve lung deposition of inhaled medication given by an asthma pump. The device makes taking medication from an asthma pump easier and more effective. Spacers should be used for all children, and for adults with troublesome asthma. Spacers should only be used with a mask in very young babies, convert to using the mouthpiece from age three. Using a spacer also reduces side effects.
AfriSpacer
Inhalers contain the medication needed to treat asthma, but the medication must be delivered to the lungs. AfriSpacer improves lung deposition of inhaled medication given by a metered dose inhaler.
The AfriSpacer can be used alone, or with the one-way AfriValve. Aerosolised medication in the air inside the spacer is breathed in efficiently to the lungs. The AfriSpacer has 1.7 times the delivery to the lungs. Delivery is higher with the AfriSpacer than nebulisers and dry powder inhalers. The AfriSpacer reduces oropharyngeal deposition to 11%.
The inhaler with a AfriSpacer is as effective as commercial spacers and as, or more effective than home nebulisers. Using AfriSpacer, rather than a nebuliser, avoids contaminating the air with exhaled respiratory droplets. For adults and children able to use a single breath inhalation technique, use the AfriSpacer directly through its mouthpiece.
Children who cannot take one breath in and hold their breath, should use the AfriSpacer with the one-way valve at the front allowing them to inhale medication with normal breathing.
For very small babies who cannot put the spacer in their mouths properly, use the AfriSpacer with AfriValve and a face-mask. Face-masks are often subject to leakage of air around the sides of the facemask.
It is important to remove a face mask and use the AfriSpacer via the valve mouthpiece as soon as a child is able to breathe in and out through their mouth without assistance.
AfriSpacer and AfriValve can be washed and reused, making it a safe, effective and durable product.
