The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Bothaina Alhaddad1, Felicity J. Smith1, Kevin M. Taylor2, Tricia Robertson3, Geoffrey P. Watman3; 1Department of Practice and Policy, The School of Pharmacy, London, United Kingdom; 2Department of Pharmaceutics, The School of Pharmacy, London, United Kingdom; 3Harrow Primary Care Trust, Harrow, United Kingdom

Background: Chronic obstructive pulmonary disease (COPD) is a global health burden and a priority for many healthcare initiatives around the world. Nebulizers are a mainstay of treatment for patients with severe COPD. Understanding how patients use their nebulizers at home is vital to ensure effective treatment and suboptimal health outcomes. This novel study employs a mixed methods approach for a detailed investigation of nebulizer use at home from patients’ perspectives. Method: A descriptive cross-sectional study design using in depth interviews, observations and survey methods was conducted among fifty patients with COPD using nebulizers at home. A representative sample including patients with different length of nebulizer use and different severity of disease was recruited from general practice populations and at hospital discharge. Qualitative and quantitative analyses were conducted to identify the range of problems experienced with nebulizer use in all stages prior, during and after inhalation of a nebulized dose. Results: All fifty patients (29 female, 21 male) (age range 54 - 91) reported experiencing one or more problems with the use of their nebulizer. Problems identified which occurred before inhalation of the nebulized dose were; complexity of setting up the equipment, lack of instructions for assembly of equipment, manual dexterity, time taken to set up the equipment, inadequate hygiene during setting up of the equipment and mishandling of the device. Problems during medication administration were; time taken to nebulize the dose, claustrophobic feelings during nebulizer use and incorrect inhalation technique or breathing patterns. Problems which occurred following administration were; inadequate cleaning of nebulizer components, poor access to accessories, e.g. face masks and tubing, cost of accessories and the use of damaged parts or self repairs. Conclusion: Findings from this study showed that COPD patients using nebulizers in their own homes experienced problems in all stages; before, during and after inhalation of medication. Healthcare providers need to be aware of the types of problems encountered in order to support effectively COPD patients with the use of their nebulizers at home to optimize health outcomes. Sponsored Research - None