PP23 COMPARING TREATMENT EFFECTIVENESS AND COSTS FOR BRONCHOSPASM IN HOSPITALIZED CHILDREN: SALBUTAMOL INHALER WITH SPACER VS. NEBULIZER – A RETROSPECTIVE STUDY

Ahmad Fadzil Abdullah, Sharifah Aishah Syed Ahmad Alsagoff, Mohammad Farhan Rusli, Muhd Alwi Muhd Helmie

Department of Paediatric, Kulliyyah of Medicine, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia

Introduction
Nebulisation has traditionally been the standard method for delivering inhaled salbutamol in children with bronchospasm. The study, conducted at Sultan Ahmad Shah Medical Centre, aimed to compare outcomes in bronchospasm-treated children using metered-dose inhalers (MDIs) with spacers versus nebulizers.

Objectives
To compare the length of stay (LOS) and treatment costs between children with bronchospasm treated with inhaled B2-agonists via MDI with spacer or nebulizer. 

Materials and methods
This retrospective cohort study, spanning from January to December 2022, involved 128 children aged between two and 12 years old. The nebulizer group data covered the period from June 2019 to March 2020, while the MDI group data spanned from March 2020 to December 2021. Patient selection utilized universal sampling, and data were extracted from patient notes. The methodology included the use of a structured pro-forma for data collection, evaluating variables such as LOS, treatment costs, cumulative salbutamol dose, heart rate, and clinical parameters.

Results
The results revealed no significant difference in LOS between the two groups. However, the MDI group demonstrated lower costs compared to the nebulizer group (RM10,486.00 vs. RM12,273.00 each treatment per hospital stayed). While differences in cumulative salbutamol dose were observed, no significant distinctions were noted in other clinical parameters.

Conclusion
The study concluded that MDI with a spacer showed similar ward stay durations but with lower costs compared to nebulizers. This underscores the economic and practical benefits of using MDI, including a reduced risk of disease transmission and decreased nursing workloads.