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Consensus Recommendations on Home Maintenance Nebulization with Focus on Obstructive Airway Diseases: An Update on
Randeep Guleria1, Sundeep Salvi2, Pranav Ish3
1Chairman, Institute of Internal Medicine & Respiratory and Sleep Medicine; Director, Medanta Medical School, Gurugram, Haryana, India.
The Journal of the Association of Physicians of India
|October 16, 2025
Summary
Home maintenance nebulization (HMN) offers an alternative for obstructive airway diseases (OADs) when inhalers are ineffective. This updated expert consensus provides evidence-based guidance for using HMN in asthma and COPD management.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Practice Guidelines
Background:
- Obstructive airway diseases (OADs) like asthma and COPD pose a significant healthcare burden, especially in low- and middle-income countries.
- Inhaler therapy is standard for OADs, but suboptimal usage is common due to patient-specific factors.
- Home maintenance nebulization (HMN) is an emerging alternative for selected patients with OADs.
Purpose of the Study:
- To update evidence-informed recommendations on the use of home maintenance nebulization (HMN) for obstructive airway diseases (OADs).
- To address knowledge gaps and optimize therapeutic protocols for HMN in asthma and COPD management.
- To support clinicians in evaluating nebulization therapy for long-term home care in OADs.
Main Methods:
- Expert consensus development based on updated research findings and clinical expertise.
- Review and synthesis of recent evidence regarding HMN efficacy and patient selection criteria.
- Incorporation of clinical experience in managing OADs with nebulization therapy.
Main Results:
- The updated consensus provides current, evidence-based recommendations for HMN in OADs.
- It addresses specific patient populations who may benefit from HMN, including those with advanced disease or limitations.
- Optimized therapeutic protocols are suggested for effective HMN implementation.
Conclusions:
- Home maintenance nebulization is a viable option for select patients with asthma and COPD, particularly when inhaler adherence or technique is suboptimal.
- This updated guidance aims to improve patient-centered care and therapeutic outcomes for OADs managed at home.
- Clinicians are better equipped to assess and implement HMN as a long-term maintenance strategy.
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