Comparative study on effectiveness of a traditional brief intervention method versus a virtual teach-to-goal approach in educating hospitalized children with asthma on proper inhaler technique

Abstract

Background: Correct inhaler technique is essential for achieving optimal asthma control in children. However, incorrect inhaler use remains common and contributes to poor disease control, recurrent exacerbations, and increased healthcare utilization. Hospitalization provides an important opportunity for inhaler education. This study compared the effectiveness of a traditional brief intervention (BI) with a Virtual Teach-to-Goal (V-TTG) approach in improving inhaler technique among children with asthma. Methods: This comparative study was conducted in the Department of Paediatrics, Pushpagiri Institute of Medical Sciences and Research Centre, Kerala, over 18 months. Sixty-six children aged 4-15 years with asthma (33 in each group) were enrolled. Participants received either conventional face-to-face inhaler education (BI) or standardized video-based V-TTG education. Inhaler technique was assessed before and after intervention using a validated 12-step metered-dose inhaler with spacer checklist. Follow-up assessment evaluated retention of correct inhaler technique. Continuous variables were analyzed using paired and independent t tests, while categorical variables were compared using Chi-square/Fisher's exact test. A p<0.05 was considered statistically significant. Results: Both educational interventions significantly improved inhaler technique scores from baseline (BI: 6.94±1.32 to 9.67±1.65, p<0.001; V-TTG: 6.91±1.51 to 10.70±1.33, p<0.001). The V-TTG group achieved significantly higher post-intervention scores than the BI group (10.70±1.33 vs. 9.67±1.65; p=0.007). At follow-up, a greater proportion of children in the V-TTG group demonstrated correct inhaler technique (75.8% vs. 63.6%), although this difference was not statistically significant (p=0.284). Older children demonstrated significantly better inhaler technique than younger children (p<0.001). Conclusions: Both traditional BI and V-TTG education significantly improved inhaler technique in children with asthma. However, the V-TTG approach resulted in superior immediate improvement in inhaler technique and represents an effective, scalable strategy for asthma education in pediatric practice.