Survey of patients' views of domiciliary nebuliser treatment for chronic lung disease

Abstract

There is some controversy amongst respiratory physicians over the value of domiciliary nebuliser use for chronic lung conditions. Most recommendations for assessment of suitability for this form of treatment rely upon response to lung function tests and reported improvements in exercise ability. Relatively little emphasis has been placed upon the patient view of this therapy. This survey examined the subjective views of patients receiving domiciliary nebulisers regarding this treatment. A postal questionnaire was sent to 82 patients using home nebuliser treatment provided by the respiratory clinic at Whipps Cross University Hospital, London. It consisted of 29 structured questions covering topics of well-being and symptom control, self-confidence, dependency, time and technical issues, as well as side effects and compliance. Most patients surveyed had chronic obstructive lung disease. For almost all sections of the questionnaire patients reported overwhelmingly that the benefits of using a nebuliser outweighed potential disadvantages. The main perceived advantages werethe ability for patients themselves to control symptoms and to be less dependent on General Practitioners, hospitals and carers. Compliance was generally excellent, and the reported side effects were minor and relatively infrequent. The results strongly support the view that nebulisers are helpful in managing chronic lung disease in the community with benefit to patient well-being and potential health cost savings.

Chronic Obstructive Pulmonary Disease: Prevalence, Characteristics, and Pharmacologic Treatment in Nursing Home Residents with Cognitive Impairment

“…For example, some patients require nebulized therapy due to comorbidities or functional impairment, while others prefer the nebulized route of administration for these medications because they feel they are more effective. 5 The GOLD and AMDA guidelines recommend a stepwise approach to therapy for patients with COPD.…”

The Use of Inhalation Therapy in the Management of Chronic Obstructive Pulmonary Disease (COPD) in the Community: A Review of Studies

“…Eleven studies examined the aspects of operation of inhalation devices and described the frequency and range of problems experienced by COPD patients when using their inhalation devices (Table 2). These studies were mostly based in outpatient clinics (N=11) (Lenney et al, 2000;Hesselink et al, 2001;George et al, 2005;Khassawneh et al, 2008;De Moraes Souza et al, 2009;Rootmensen et al, 2010;Melani et al, 2011;Agh et al, 2011 ;Cecere et al, 2012;Huetsch et al, 2012;Khdour et al, 2012), and patients' home (N=5) (Melani et al, 2001;Barta et al, 2002;Boyter and Carter, 2005;George et al, 2006;Sestini et al, 2006). Others were based in community pharmacies (N=3) (Hämmerlein et al, 2011;Mehuys et al, 2010;Trivedi et al, 2012).…”

“…Most of these studies were conducted in Europe, especially the UK (N=6) (Lenney et al, 2000;Barta et al, 2002;Ho et al, 2004;Boyter and Carter, 2005;Wilson et al, 2007;Khdour et al, 2012), followed by Italy (N=3) (Melani et al, 2001;Sestini et al, 2006;Melani et al, 2011), and the Netherlands (N=1) (Rootmensen et al, 2010), Belgium (N=1) (Mehuys et al, 2010), Hungary (N=1) (Agh et al, 2011), France (N=1) (Hesselink et al, 2001), Germany (N=1) (Hämmerlein et al, 2011), the USA (N=3) (Cecere et al, 2012;Huetsch et al, 2012;Trivedi et al, 2012), Australia (N=2) (George et al, 2005;George et al, 2006), Brazil (N=1) (De Moraes Souza et al, 2009) and Jordan (N=1) (Khassawneh et al, 2008).…”

“…Except for six studies which were conducted on a large national scale (Molimard et al, 2003;George et al, 2006;Wilson et al, 2007;Cecere et al, 2012;Rootmensen et al, 2010;Trivedi et al, 2012), and two were survey studies (Barta et al, 2002;Boyter and Carter, 2005). The sample size in these studies ranged from 28 to 2,730 COPD patients (George et al, 2006;Huetsch et al, 2012).…”

Effects on Aerosol Performance of Mixing of Either Budesonide or Beclomethasone Dipropionate With Albuterol and Ipratropium Bromide

“…Likewise, some elderly patients prefer nebulizer, not only for acute severe episodes of bronchospasm, but for regular long-term home use. [2][3][4] An exhaustive literature review revealed that there is a paucity of randomized controlled studies on nebulization of corticosteroids, as most research trials have employed metereddose inhalers. 1 Additionally, although in vitro experiments can be a surrogate for in vivo investigation of respiratory drug delivery, 5 extensive information about nebulized corticosteroids from in vitro studies is still not available.…”