Q: My son’s asthma specialist recommended I put a valved holding chamber on his bronchodilator inhaler. How do they work and why are they important?
Purvi Parikh, MD: A valved holding chamber is a handheld device that attaches to a metered-dose inhaler (MDI) and captures the asthma medication as it sprays out. The medication is trapped inside the holding chamber long enough for you to inhale it at your own speed.
Valved holding chambers are very important because they can increase how much medication is delivered into your lungs. The average inhaler – even when used correctly – only delivers about 60 percent of medication into the lungs, where it needs to go.
The valved holding chamber allows you to better streamline delivery of the medication so more of it can get into your lungs and thus be more effective in controlling your asthma. It can also pull out larger particles of medication unable to make it into your narrow airways, keeping them from settling in your mouth or throat.
Q: How do you coach patients to ensure they use their valved holding chamber consistently?
Dr. Parikh: After stressing the importance of valved holding chambers, I usually encourage patients to keep their device right next to their asthma inhaler so they don’t forget to use it.
The good news is, there are some inhalers that come with the holding chambers already attached, and that may be more helpful for those patients who find it burdensome to remember to use it all the time.
It’s often helpful – especially for children – to use a mask that attaches to the valved holding chamber. It should fit over the mouth and nose and allow the user to take several breaths to inhale the medication fully.
Q: Does the valved holding chamber need to be cleaned?
Dr. Parikh: Yes, it’s very important to clean it because if you don’t, it can collect dust mites and mold – allergens that can often make your asthma worse.
Valved holding chambers should be washed at least once a week if used every day. Read and follow package instructions on proper cleaning – some can even go in the dishwasher.
Q: Are patients able to get valved holding chambers free of charge through their insurance?
Dr. Parikh: Not always. Some insurance plans will cover it, some won’t. The good news is the cost of valved holding chambers is not very high – they are around $10-15 apiece. So if you do have to pay out of pocket, they are affordable. And they do last you some time.
Purvi Parikh, MD, is a board-certified allergist and immunologist with Allergy and Asthma Associates of Murray Hill and New York University School of Medicine in New York City. She also serves on the Board of Directors for the Advocacy Council of the American College of Allergy, Asthma and Immunology.
Have a medical question? Email editor@allergyasthmanetwork.org or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.
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