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GENebu Project: home nebulizer use and maintenance in Italy

¹ U.O. Fisiopatologia Respiratoria, Policlinico Le Scotte, Azienda Ospedaliera Senese, Siena; ² Clinica Malattie Apparato Respiratorio, Università di Siena, Siena; ³ U.O. Riabilitazione Respiratoria, Ospedale S.Marta, Rivolta d'Adda; ⁴ Divisione di Pneumologia, Ospedale da Procida, Salerno; ⁵ Divisione di Pneumologia, Ospedale S.Andrea, La Spezia; ⁶ U.O. Broncopneumologia e Riabilitazione Respiratoria, Ospedale Forlanini, Roma; ⁷ Area Territoriale Tisio-Pneumologica, Vicenza; ⁸ U.O. Fisiopatologia Respiratoria, Azienda Ospedaliera Barese, Bari; ⁹ Presidio di Tisio-Pneumologia, Azienda Città di Bologna, Bologna; ¹⁰ Divisione di Pneumologia, Centro Medico di Tradate, I.C.C.R.S. Fondazione Maugeri, Tradate, Italy

CORRESPONDENCE: A.S. Melani, U.O. Fisiopatologia Respiratoria, Policlinico Le Scotte, Azienda Ospedaliera Senese, Viale Bracci, I-;53100-Siena, Italy. Fax: 39 0577586196

Keywords: aerosol, asthma, chronic obstructive pulmonarydisease, clinical practice, home care, nebulizer therapy

Received: March 27, 2001
Accepted June 28, 2001

The authors wish to thank Sapio Life, Monza for financial support in performing this survey.

Due to the lack of information on this topic, the Educational Group of the Italian Association of Hospital Pneumologists performed an open, multicentre, observational survey to evaluate home nebulizer practices in Italy.

From May–December 1999, all patients attending one of the 27 participating chest clinics throughout Italy and who were or had been using a home nebulizer in the previous 6 months were consecutively enrolled. All patients completed a self-administered questionnaire on their current practices of home nebulization.

Of the 1,721 questionnaires delivered, 1,257 were returned with an overall response rate of 73%. Most patients (82.8%) reported using their nebulizer for bronchopulmonary symptoms and the remaining patients only used theirs for upper respiratory tract diseases. Subjects using their nebulizer for lower respiratory symptoms were older (p<0.001), predominantly female (p<0.001) and used their nebulizer more frequently (p<0.001). Forty per cent of patients >60 yrs old used their nebulizer regularly, at least once a day. More than 60% of respondents never received any information from healthcare workers on the correct usage of their nebulizer, and >75% received no information on nebulizer hygiene and care. Patients who received information on the use and maintenance of their nebulizer from caregivers more commonly attended to these practices (p<0.01).

The present survey suggests that home nebulizer use and maintenance in Italy are heterogeneous, and there is the need to implement better nebulizer practice.