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Emergency physicians' preferences in bronchodilator delivery for asthma exacerbations: a cross-sectional study
Abdullah K Almutairi1,2, Faisal A AlGhamdi3, Dana Althawadi4
1Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Summary
Physicians often prefer nebulizers for asthma exacerbations, despite studies showing metered dose inhalers (MDI) with spacers are equally effective. Barriers to MDI adoption include availability and perceived ineffectiveness in young patients.
Area of Science:
- Pulmonology
- Emergency Medicine
- Pharmacology
Background:
- Asthma exacerbations frequently require emergency department (ED) visits.
- Bronchodilators are key in managing acute asthma, with nebulizers and metered dose inhalers (MDI) being common delivery methods.
- Despite comparable efficacy, a physician preference for nebulizers persists in clinical practice.
Purpose of the Study:
- To investigate physician demographics, knowledge, beliefs, and current practices regarding bronchodilator therapy for asthma exacerbations.
- To understand the reasons behind the continued preference for nebulizers over MDIs in acute asthma management.
Main Methods:
- A questionnaire-based survey was distributed to physicians treating asthma exacerbations.
- The survey collected data on physician demographics, attitudes, and treatment preferences for bronchodilator delivery.
Main Results:
- Over 90% of physicians prefer short-acting beta-agonists via nebulizer, though most (90.1%) acknowledge MDI with spacer is equally effective.
- Cited advantages for MDI include cost-effectiveness, shorter ED stays, quicker administration, and ease of use.
- Key barriers to MDI use are availability (66.4%) and perceived ineffectiveness in younger patients (45%).
Conclusions:
- Physician preference for nebulizers in acute asthma management persists despite evidence supporting MDI efficacy.
- Addressing concerns about MDI availability and effectiveness in pediatric populations is crucial for wider adoption.
- A significant proportion of physicians are willing to switch to MDIs with spacers, suggesting potential for change with improved resources and training.
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