Video education versus face-to-face education on intranasal steroid administration technique for rhinitis pediatric patients and their caregivers

Abstract

Background: Allergic rhinitis is a common disease and prevalence is increasing worldwide.
Intranasal steroid is the main treatment to control symptoms. Correct administration
technique of intranasal steroid can increase the effectiveness of treatment and further reduce
the side effects of this medication.
Objectives: To compare the accuracy of INS administration techniques between a groups
who were instructed by a doctor and those watching videos. And to evaluate the step of
incorrect INS technique in pediatric rhinitis patients and their caregivers in Chonburi
hospital.
Method: The study was a prospective randomized controlled trial in rhinitis patients aged
between 2-15 years with incorrect INS administration technique from July 2020 to July
2021. The patients were randomly assigned into 2 groups to be instructed how to use INS;
1) by a doctor (face to face) and 2) by watching videos. The patients were evaluated INS
administration technique immediately after teaching. If they were unable to use INS correctly,
the same instruction was repeated and a reassessment was performed.
Results: A total of 60 patients, 30 each group were randomized. The most two common
errors were “exhale through their mouths while removing the tip of the nasal spray from
their noses (correctly perform 5%) and squirt a spray of mist in the nose while breathing
in” (correctly perform 46.7%). There was no statistically significant difference in the correct
step between two groups. After instruction, the accuracy of all administration technique
was no statistically significant difference between two groups (100% in face to face vs
96.7% in VDO, p=1). Only one patient in VDO group is unable to perform correctly all
steps therefore the same instruction was repeated. Second assessment was performed and
found that all steps are correct. None of the patients was considered an INS administered
instruction failure.
Conclusions: Education about INS administration technique improve the accuracy of INS
use. Education by watching VDO is as effective as face to face method. Video is useful,
easy method, can watch repeatedly and also decrease medical personnel workload. However,
the doctor should always check the administration technique to remind patients of the correct
INS use method to improve the effectiveness of treatment and further reduce the side effects
of this medication.