The use of asthma spacers for asthma management has been widely accepted for years. However, a remaining concern is that incorrect use of a spacer is common and may lead to poor asthma control. Asthma spacers can be used in conjunction with short acting beta agonists and inhaled corticosteroids. Coordinating device sprays while inhaling an asthma medication can be particularly challenging for some patients. Asthma spacers can reduce drug deposition in the oropharynx and improve lung deposition. Some experts recommend routine use of asthma spacers, but the real life effectiveness has not been studied. A spacer may add to the complexity of using an inhaler and lead to more errors. In a study published in the Journal of Allergy and Clinical Immunology: In Practice, the researchers sought to determine the true benefits of spacer use. The study used real world clinical date to compare outcomes for asthma patients using inhalers with and without spacers.
Patients were age 12-80 years old, had a history of asthma, and were using an inhaled corticosteroid (beclomethasone dipropionate or fluticasone propionate), with or without a spacer.
Results: There was no significant difference in number of severe exacerbations over 1 year for patients with or without a spacer, for both types of inhaled corticosteroids. Secondary outcomes were similar as well. There wasn’t much of a difference for acute respiratory events, asthma control measures, asthma-related hospitalizations, emergency room visits, treatment stability or incidence of thrush.
This study included adolescents and adults only. For patients less than 12 years old, there are no conclusions made. Many younger children seem to benefit well with spacers, so do not discontinue them if there asthma is well controlled. Speak to your asthma doctor if an asthma spacer is right for you or your child. Every asthma patient is unique and some will benefit from a treatment whereas others may not. Based on this study though, it seems that the routine use of asthma spacers is questionable for patients aged 12 and up. The findings challenge the belief that asthma spacers increase drug delivery to the lung.