PURPOSE: To ascertain pattern of nebulization practice amongst medical practitioners in private setting in the community.
METHODS: A detailed questionnaire was sent to 1,000 practicing physicians comprising of 600 general practitioners (GP's), 200 paediatricians, 150 medical specialists (internists) & 50 qualified chest physicians. There were 8 items in the questionnaire. Out of 1000, only 200 physicians responded & completed the questionnaire (20%) & these were: 80 (40%) GP's; 50 (25%) Paediatricians; 40 chest physicians (20%) and 30 internists (15%).
RESULTS: The common drugs nebulized were: Salbutamol (80%);Budesonide (65%); Combination of Salbutamol & Ipratropium (60%). Common indications for nebulization in the community were: Acute Severe Asthma, Acute Exacerbation of COAD, Acute Broncholitis (Post Viral), Acute Exacerbation of interstitial lung disease & Unexplained acute respiratory distress. Home nebulizers were mostly prescribed by chest physicians; majority (95%) used direct nebulization without oxygen; only 5% used oxygenation to drive the nebulized drug -these were mostly chest physicians; pediatricians & chest physicians preferred face mask whereas GPs & internists used directly the mouth piece. Trained practicing nurse/respiratory therapist was available to supervise or instruct nebulization technique in less than 5% of practices; majority (> 85%) used nebulizers for short periods & did not wait till the chamber was fully emptied of the solution; only 10% of practicing physicians believed in continuous nebulization.
CONCLUSION: There were wide variation in nebulizer use amongst the practicing physicians. There was no homogeneity in the methods used for nebulization. Education & demonstration of appropriate further skills is required. Funding: None.
CLINICAL IMPLICATIONS: Routine nebulization for aerosol drug delivery in Acute Exacerbation of Asthma & COPD is a well established therapy. However, precise information on pattern of prevalent practices is lacking from this region. Hence a survey was conducted in May 2005 in the twin cities of Hyderabad, Secunderabad in South India.
DISCLOSURE: Ajit Vigg, No Financial Disclosure Information; No Product/Research Disclosure Information