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How do patients use their nebulisers in the community?

Boyter, A.C. (2005) How do patients use their nebulisers in the community? Respiratory Medicine, 99 (11). pp. 1413-1417. ISSN 0954-6111

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Nebulisers are commonly used in the management of airways disease and are the subject of a British Thoracic Society (BTS) Guideline.1 The majority of nebulisers are used for the delivery of beta agonists and anticholinergic agents and less commonly for steroids and antiinfective agents. They are used both in acute situations and in maintenance regimens. Patients with chronic obstructive pulmonary disease (COPD) are often prescribed both a bronchodilator and an anticholinergic agent on a regular basis while asthmatic patients, using a nebuliser, may either take their medication as required or on a regular basis.2 and 3 For the majority of patients maintained on nebulised agents at home, a jet nebuliser, which comprises a nebulising chamber and an electrical compressor, is used for the delivery of the drugs. Within the BTS guideline1 for the use of nebulisers there are some suggestions4 for the maintenance of the compressor and the replacement of the consumables required for efficient operation of the nebulisers. These suggest that the compressor should be serviced annually; at this time the filter is normally replaced on the compressor. Consumables, mouthpiece, mask and tubing should be replaced regularly at 3–6 monthly intervals and the nebuliser chamber should be washed in hot soapy water, rinsed and left to dry naturally once daily. It is also suggested that patients should receive an information leaflet and instruction on how to use the equipment. Previous studies on the compliance with therapy have either optimised the patient's technique, with repeated instruction5 or have used electronic devices to log the use of the nebuliser.6 To our knowledge this is the first study that relies on patient reported data and also investigates the patients cleaning and maintenance of their nebulisers. The aim of this study was to survey patients who had received a nebuliser from the respiratory unit at Glasgow Royal Infirmary to ascertain how they use and maintain their nebuliser at home and what if any, side effects relating to their treatment.