The use and misuse of domiciliary nebulizer therapy on the Isle of Wight

Domiciliary nebulizer use is evaluated in a well-defined population on the Isle of Wight covering all ages. A questionnaire was administered to 167 known users and all were completed. The indication for nebulizer therapy was asthma (137), bronchitis (32) and emphysema (30). Twenty-three had never had a simple inhaler device prescribed and, of the others, 13 had never had instruction in its use. One hundred and fifty-three had used the nebulizer within the previous year and, of these, instruction was provided by physiotherapist (87), general practitioner (30), nurse (19) and hospital doctor (6). Nine received no advice. The drugs used comprised mostly salbutamol (140) and sodium cromoglycate (51). Twenty-six mixed medicines for use in the nebulizer and 24 admitted to exceeding the recommended dose. Twenty-three patients had a peak flow meter available at home. With treatment failure, 108 would call a doctor or report to hospital, while 25 would persist with nebulizer therapy. Thirty-two patients had no help at home in the event of an emergency. Most patients thought that they benefited greatly from nebulizer treatment at home, but better selection of patients and monitoring of treatment is needed. Comparison with previous studies suggests that there has been little improvement in the domiciliary use of nebulizers.