SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

12/9/05

How do patients use their nebulizer in the community?

Summary
Background - Published guidelines describe standards for use and maintenance of nebulizers in out-patient care of patients with asthma and COPD.

Findings - An anonymous postal questionnaire about use and maintenance of nebulizers was sent to 200 adult patients that had been in contact with the Nebulizer Service of the Glasgow Royal Infirmary in Scotland. Based on questionnaires completed by 117 of these patients, the authors found that patient compliance with maintenance, servicing, following drug regimens and consumables replacement was quite poor (<50% of those responding). The most commonly reported side effects of the nebulizer treatments were tremor, dry mouth and chest tightness.

Reference
Respir Med 2005;99:1413-17

Editor's Comments
The finding of quite poor compliance with prescribed use of nebulizers at home, despite apparently adequate initial instructions is discouraging. Perhaps the older age (median = 69 years) of this study population could partially explain inattention to detail. It appears that repeated, simple instructions are needed.

However, the poor use of nebulizers, a relatively expensive treatment approach, should raise further question why this approach was used since several studies have shown similar clinical efficacy of either inhaled beta agonists or corticosteroids when delivered by power nebulizers or the less expensive metered dose inhaler equipped with a valved holding chamber (see review of this subject by a committee of experts in Chest 2005;127:335-71)

 

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