Background: A pressurized metered-dose inhaler (pMDI) attached to a valved holding chamber with mask has been widely used for delivering pressurized drug aerosol for asthma treatment in young children. Although many commercial valved holding chambers with mask are available in the market but they are quite expensive or unavailable in some developing countries. DIY Spacer is a lowcost, do-it-yourself (DIY) plastic bottle with syphon pump which can be used as an alternative to the commercial valved holding chamber with mask. The main advantage of DIY Spacer is that it can be made easily with simple and inexpensive materials found around the house. However, there is no scientific study to evaluate its treatment effectiveness.

Objective: The aim of the present study is to compare the treatment effectiveness and the caregiver’s drug compliance, the accuracy of inhalation techniques and the caregivers’ satisfaction with the spacers between the DIY Spacer and the AeroChamber.

Materials and Methods: A randomized, two-consecutive-month, two-sequence crossover study was conducted on 30 children with uncontrolled asthma aged less than or equal 6 years who received an inhaled therapy using a pMDI attached to a valved holding chamber with mask for the first time. The patients were randomly assigned to receive treatment using the pMDI with either a DIY Spacer or an AeroChamber (15 patients each) as a first spacer for two-consecutive months. Afterwards, a crossover treatment was employed in which the patients switched to use another spacer for the next two-consecutive months. As a result, each patient would administer each spacer for two-consecutive months. The level of control, the caregiver’s drug compliance and the accuracy of inhalation techniques were evaluated every month during the treatments, whereas, the caregivers’ satisfaction with the spacers was evaluated after each treatment.

Results: The comparing results of the level of control, the caregiver’s drug compliance and the accuracy of inhalation techniques between the DIY Spacer and AeroChamber were not significantly different (p>0.05). However, there were significantly different (p<0.05) on the satisfaction of the pMDI drug administration in which the AeroChamber received a higher satisfaction.

Conclusion: For inhaler therapy in young children with uncontrolled asthma, the treatment with the pressurized metered-dose inhaler (pMDI) with DIY Spacer is as effective as the treatment with AeroChamber in terms of the level of asthma control and caregiver’s drug compliance and the accuracy of inhalation techniques.

Keywords: Valved Holding Chamber with Mask, Spacer, Asthma, Pressurized metered-dose inhaler, DIY spacer