Evidence map›Paper›PMID 30662579›Full record

ArticleCanadian respiratory journal2018

Errors in Aerosol Inhaler Use and Their Effects on Maternal and Fetal Outcomes among Pregnant Asthmatic Women (Subanalysis from QAKCOP Study).

Wanis H Ibrahim, Fatima Rasul, Mushtaq Ahmad, Abeer S Bajwa, Laith I Alamlih, Anam M El Arabi, Dhabia Al-Mohannadi, Mohammed Y Siddiqui, Israa S Al-Sheikh, Azdin A Ibrahim

Open access · goldAbstract read
In one paragraph

Article in Canadian respiratory journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 76% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Dry Powder Inhalers for Delivery of Synthetic Biomolecules.Pharmaceuticals (Basel, Switzerland) · 2025
    Review
  2. Treatable Traits in Pregnant Women with Asthma.Respiration; international review of thoracic diseases · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Wanis H IbrahimSenior Consultant Pulmonologist and Professor of Clinical Medicine, Department of Medicine, Hamad General Hospital and Weill-Cornell Medical College, Doha, Qatar.ORCID 0000-0001-6298-9959
Fatima RasulConsultant Physician, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Mushtaq AhmadPulmonary Fellow, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Abeer S BajwaMedical Resident, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Laith I AlamlihMedical Fellow, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Anam M El ArabiPulmonary Fellow, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Dhabia Al-MohannadiSr. Consultant Physician, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Mohammed Y SiddiquiInternal Medicine Resident, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Israa S Al-SheikhInternal Medicine Resident, Hamad General Hospital, Doha, Qatar.
Azdin A IbrahimGynecologist and Obstetrician, St. Josefs Hospital, Wiesbaden, Germany.
Hamad General Hospital · QASt. Josefs Hospital · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Data on inhaler technique and its effects on maternal and fetal outcomes during pregnancy are seldom reported. The primary objective of this study was to evaluate inhaler technique and identify errors in inhaler use among pregnant women with asthma. Secondary objectives were to identify factors associated with poor inhaler technique and study the association between inhaler technique and maternal and fetal outcomes. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. Seventy-three and 41 asthmatic pregnant women reported using pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs), respectively. Overall, wrong inhaler technique was observed in 47 (64.4%) subjects. Among pMDI users, correct inhaler use was observed in only 26/73 (35.6%) of the patients, with lack of coordination between inhalation and generation of the aerosol and failure to breathe out gently before using the inhaler, being the most common errors. Among DPI users, 21 (51.2%) demonstrated correct inhaler use, with failure to perform a breath-hold for 10 seconds after inhaling the powder and to exhale gently before using the inhaler being the most common errors. Significant associations between inhaler technique and patient's understanding of asthma medications and the kind of follow-up clinic (respiratory versus nonrespiratory clinic) were found. No significant associations between inhaler technique and various maternal and fetal outcomes or asthma control were found. In conclusion, improper inhalation technique is significantly prevalent in pregnant asthmatic women, particularly among those being followed in nonspecialized respiratory clinics. The lack of significant association between the inhaler technique and asthma control (and hence maternal and fetal outcomes) may simply reflect the high prevalence of uncontrolled asthma and significant contribution of other barriers to poor asthma control in the current patient's cohort. Multidisciplinary management of asthma during pregnancy with particular emphasis on patient's education is imperative.

Indexed as

Patient Medication KnowledgeAdministration, InhalationAdultAlbuterolAnti-Asthmatic AgentsAsthmaBudesonideBudesonide, Formoterol Fumarate Drug CombinationCesarean SectionCongenital AbnormalitiesCross-Sectional StudiesDisease ProgressionDry Powder InhalersFemaleFluticasone-Salmeterol Drug CombinationHumansAlbuterolAnti-Asthmatic AgentsBudesonideBudesonide, Formoterol Fumarate Drug CombinationFluticasone-Salmeterol Drug Combination

Identifiers

PMID30662579
PMCPMC6312601
OpenAlexW2903750182

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.