Nebulizer therapy in cystic fibrosis: An overview

Collins, Nicola

doi:10.1258/jrsm.2009.s19003

Cited by 20 publications

(11 citation statements)

References 12 publications

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“…Inadequate prescription, brief periods of nebuliser overuse or taking nebulised antibiotics with insufficient dose spacing could inflate 'unadjusted' adherence (Hoo et al, 2016), and it is possible that a person with moderate levels of effective adherence was inadvertently labelled as a high adherer in this study. Technique errors with using nebuliser were also not considered, although I-neb ® is a third-generation adaptive aerosol delivery system designed to optimised technique by only releasing aerosol when an inhalation of sufficient quality is detected (Collins, 2009).…”

Section: Discussionmentioning

confidence: 99%

Determinants of objective adherence to nebulised medications among adults with cystic fibrosis: an exploratory mixed methods study comparing low and high adherers

Hoo

Boote

Wildman

et al. 2017

Health Psychology and Behavioral Medicine

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Objectives: Adherence to nebulised treatment is typically low among people with cystic fibrosis (CF). This study sought to identify factors differentiating high or low nebuliser adherence patterns (i.e. ≥80% or <50% of all nebulised treatments over one year) among adults with CF. Design: A mixed methods cross-sectional exploratory comparison of low and high adherers to nebulised medications. Methods: Of 36 eligible adults invited from a UK CF centre, 20 were recruited (10 high, 10 low adherers). Adherence was objectively measured using electronic data capture. Participants completed a self-report questionnaire comprising measures of hypothesised predictors (habit, self-control, life chaos, perceived treatment burden, capability, motivation and opportunity), then took part in a semi-structured interview. Quantitative data were compared between groups, and interview data were thematically analysed. Results: High adherers reported stronger habit and greater opportunities, though habit and perceived opportunity scores were highly positively correlated. No other quantitative measure distinguished between groups. Habitual instigation tendency attenuated the relationship between treatment complexity and perceived treatment burden. Indeed, in interviews, high adherers reported that routinisation and greater automaticity made treatment burden more manageable. Conclusions: High adherers seized more opportunities for nebuliser use, adapted their lives more effectively to using nebulisers and were more likely to make nebuliser use habitual. Nebuliser adherence interventions among adults with CF might usefully target development of routines for instigating nebuliser use, and identification of opportune moments for nebuliser use

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Section: Discussionmentioning

confidence: 99%

Determinants of objective adherence to nebulised medications among adults with cystic fibrosis: an exploratory mixed methods study comparing low and high adherers

Hoo

Boote

Wildman

et al. 2017

Health Psychology and Behavioral Medicine

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“…Also, the eFlow costs ca. €560, plus the annually A c c e p t e d M a n u s c r i p t replaced parts [57], whereas the PARI LC PLUS/Pulmo-Aide system costs ca. €125 in various certified online stores.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary drug delivery systems for antimicrobial agents: facts and myths

Falagas

Michalopoulos

Metaxas

2010

International Journal of Antimicrobial Agents

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To cite this version:Matthew E. Falagas, Argyris Michalopoulos, Eugenios I. Metaxas. Pulmonary drug delivery systems for antimicrobial agents: facts and myths. International Journal of Antimicrobial Agents, Elsevier, 2009, 35 (2) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…These include the drug dosage, the specific characteristics of the drug being administered such as particle size, aerosol density, and airflow speed, and patient factors such as severity of lung disease, age, cognitive and physical abilities, respiratory rate, tidal volume, and adherence with treatments. 71,167 Knowledge of inhalation therapy medications will assist the prescriber in choosing the best device for the patient. The success of inhalation therapy is highly dependent on indication, the administration device and the inhalation technique.…”

Section: Order Of Medications and Timingmentioning

confidence: 99%

Airway Clearance Strategies in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Main

Grillo²,

Rand³

2015

Semin Respir Crit Care Med

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Many patients with cystic fibrosis (CF) and non-CF bronchiectasis present with common symptoms in clinical domains that appear to benefit from airway clearance strategies. These symptoms include chronic productive cough, retention of excessive, purulent mucus in dilated airways, impairment of normal mucociliary clearance (MCC), atelectasis, breathlessness, fatigue, respiratory inflammation, fever, infection, and airflow obstruction. Airway clearance strategies may involve singular and focused interventions for the purpose of removing secretions and improving lung recruitment and gas exchange in patients with atelectasis. Strategies may also involve indirect or adjunctive interventions that facilitate or enhance effective airway clearance at different ages or stages of the disease process, for example, inhalation therapy, exercise, oxygen therapy, or noninvasive ventilation. The aim is to optimize care by selecting any one or combination of these in responding intelligently and sensitively to individual and changing patient requirements during their lifetime. Currently, a solid evidence base does not exist for airway clearance strategies in CF and non-CF bronchiectasis, and much of airway clearance clinical practice remains in the domain of clinical expertise. The paucity of evidence is partly explained by the relatively immature research machinery in allied health care internationally but is also partly to do with inadequate or inappropriate research designs. This article aims to provide an overview of the nature of, and physiological basis for, the direct and indirect airway clearance strategies in CF and non-CF bronchiectasis with reference to the best available evidence.

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Nebulizer therapy in cystic fibrosis: An overview

Cited by 20 publications

References 12 publications

Determinants of objective adherence to nebulised medications among adults with cystic fibrosis: an exploratory mixed methods study comparing low and high adherers

Determinants of objective adherence to nebulised medications among adults with cystic fibrosis: an exploratory mixed methods study comparing low and high adherers

Pulmonary drug delivery systems for antimicrobial agents: facts and myths

Airway Clearance Strategies in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

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