Assessment and provision of home nebulizers for chronic obstructive pulmonary disease (COPD) in the Yorkshire region of the U.K.

Abstract

A survey was undertaken to determine the current practice in the Yorkshire Health Region for the assessment and provision of home nebulizers for adults with chronic obstructive pulmonary disease (COPD). A detailed postal questionnaire on assessment methods was sent to each of the 22 consultant physicians in respiratory medicine. The 17 consultants who also organized the adult home nebulizer service for their health district were asked about the services offered and funding for the service. Replies were received from all consultants. All physicians use objective measurement for assessing patients for home nebulizer therapy, but there is a variable emphasis on laboratory studies, walking distance and home trials with peak flow measurements. The majority (86%) incorporate a home trial into their assessment. Many physicians also take into account subjective response to nebulized bronchodilators. There is considerable variation in the provision and funding of home nebulizer services. Those districts with a coordinated service appear to offer a more comprehensive service. A consensus on nebulizer provision, with recommendations for minimum levels of provision in each health district, should result in a more uniform delivery of service.

Overview of nebuliser treatment

“…In a UK regional survey, 5 for instance, acy. The development of national (UK, BS 5724) and international (European, IEC compressor use for domiciliary treatment varied between districts from four to 213 per 601-1) standards should act as a stimulus in this direction.…”

Quality of life measurements and bronchodilator responsiveness in prescribing nebulizer therapy in COPD

“…1 The provision of nebulizers however, is variable both in the UK and other European countries. 2,3 This may be related to a number of factors including local funding priorities, patient and physician expectations and differing expert opinion on the efficacy of stepping up bronchodilator therapy dose with a suitable device as compared to nebulized treatment. 4 The current British and European guidelines recommend nebulizer use in patients requiring high doses of inhaled bronchodilator or in patients who are unable to use other devices.…”