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Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers

Background: Activating pressurised metered dose inhalers (pMDI) is often challenging for children. Easy Squeezy (ES), is a novel sleeve attachment device that reduces this activation force by from 46N to 12.6N and monitors the remaining doses using its built-in counter. Objectives: The primary objec...

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Main Author: Mapondela, Kassim
Other Authors: Levin, Michael
Format: Thesis
Language:English
English
Published: Department of Paediatrics and Child Health 2026
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access_status_str Open Access
author Mapondela, Kassim
author2 Levin, Michael
author_browse Levin, Michael
Mapondela, Kassim
author_facet Levin, Michael
Mapondela, Kassim
author_sort Mapondela, Kassim
collection Thesis
description Background: Activating pressurised metered dose inhalers (pMDI) is often challenging for children. Easy Squeezy (ES), is a novel sleeve attachment device that reduces this activation force by from 46N to 12.6N and monitors the remaining doses using its built-in counter. Objectives: The primary objective of this study was to examine the usability and patient experience of the ES sleeve attachment device in the paediatric patient population and, to assess clinical outcomes (lung function, asthma control and quality of life) when using a novel sleeve attachment device for pressurised metered dose inhalers (pMDI) compared to using pMDI without the novel sleeve attachment. Methods: The usability cross-sectional study included 40 participants between the ages of 5 to 10 years, half of whom had prior experience in using a pMDI. Participants and their parents recorded their responses on the ease of use, perceptions and satisfaction with using the pMDI alone and the pMDI with the ES. The longitudinal cohort clinical study included 55 asthmatic children between the age of 5 and 12 years randomised into two groups. One group used ES for 6 weeks while the other group used pMDI. After 6 weeks the participants crossed over to the other group. Lung function test parameters were measured before randomisation and after each 6 weeks of device use. Quality of life information (PAQLQ) and child asthma control test (C-ACT) were measured after each period of device use. Results: The participants and their parents preferred ES to pMDI alone and felt happier using the ES device (100% in experienced vs 95% in inexperienced). They felt it was easier for them to activate the pMDI using ES. They expressed that the built-in counter in ES will make it easier to keep track of the doses. There was no significant difference in the baseline lung function between the groups in the clinical study. ES group had significantly lower percentage difference between pre- and post-bronchodilator FEV1 ( -6.5±15.7; FEV1/FVC: 2.5±7.5) vs (FEV1: 3.5±14.6; difference in FEV1: 3.4±13.8; FEV1/FVC: -2.6±7.4). Although no significant differences were observed in PAQLQ scores between the groups, more patients in the ES group had improvement of PAQLQ than the group using pMDI alone. Total C-ACT scores were significantly higher for the ES group. Conclusion: The Easy Squeezy device improves patient satisfaction and asthma control and may improve users' quality of life. Key words: Keywords: Pressured metered dose inhaler, children, Easy Squeezy, quality of life, lung function, asthma, asthma control.
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institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:32:06.010Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2026
publishDateRange 2026
publishDateSort 2026
publisher Department of Paediatrics and Child Health
publisherStr Department of Paediatrics and Child Health
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/43085 Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers Mapondela, Kassim Levin, Michael Dey, Roopam children device dose Background: Activating pressurised metered dose inhalers (pMDI) is often challenging for children. Easy Squeezy (ES), is a novel sleeve attachment device that reduces this activation force by from 46N to 12.6N and monitors the remaining doses using its built-in counter. Objectives: The primary objective of this study was to examine the usability and patient experience of the ES sleeve attachment device in the paediatric patient population and, to assess clinical outcomes (lung function, asthma control and quality of life) when using a novel sleeve attachment device for pressurised metered dose inhalers (pMDI) compared to using pMDI without the novel sleeve attachment. Methods: The usability cross-sectional study included 40 participants between the ages of 5 to 10 years, half of whom had prior experience in using a pMDI. Participants and their parents recorded their responses on the ease of use, perceptions and satisfaction with using the pMDI alone and the pMDI with the ES. The longitudinal cohort clinical study included 55 asthmatic children between the age of 5 and 12 years randomised into two groups. One group used ES for 6 weeks while the other group used pMDI. After 6 weeks the participants crossed over to the other group. Lung function test parameters were measured before randomisation and after each 6 weeks of device use. Quality of life information (PAQLQ) and child asthma control test (C-ACT) were measured after each period of device use. Results: The participants and their parents preferred ES to pMDI alone and felt happier using the ES device (100% in experienced vs 95% in inexperienced). They felt it was easier for them to activate the pMDI using ES. They expressed that the built-in counter in ES will make it easier to keep track of the doses. There was no significant difference in the baseline lung function between the groups in the clinical study. ES group had significantly lower percentage difference between pre- and post-bronchodilator FEV1 ( -6.5±15.7; FEV1/FVC: 2.5±7.5) vs (FEV1: 3.5±14.6; difference in FEV1: 3.4±13.8; FEV1/FVC: -2.6±7.4). Although no significant differences were observed in PAQLQ scores between the groups, more patients in the ES group had improvement of PAQLQ than the group using pMDI alone. Total C-ACT scores were significantly higher for the ES group. Conclusion: The Easy Squeezy device improves patient satisfaction and asthma control and may improve users' quality of life. Key words: Keywords: Pressured metered dose inhaler, children, Easy Squeezy, quality of life, lung function, asthma, asthma control. 2026-04-09T09:27:36Z 2026-04-09T09:27:36Z 2023 2026-04-09T09:14:11Z Thesis / Dissertation Masters Masters http://hdl.handle.net/11427/43085 en eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town
spellingShingle children
device
dose
Mapondela, Kassim
Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
thesis_degree_str Master's
title Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
title_full Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
title_fullStr Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
title_full_unstemmed Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
title_short Assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
title_sort assessing user feedback and clinical outcomes when using a novel sleeve attachment device providing reduced activation force and a built in dose counter for pressurised metered dosage inhalers
topic children
device
dose
url http://hdl.handle.net/11427/43085
work_keys_str_mv AT mapondelakassim assessinguserfeedbackandclinicaloutcomeswhenusinganovelsleeveattachmentdeviceprovidingreducedactivationforceandabuiltindosecounterforpressurisedmetereddosageinhalers