PHYSICIANS PERSPECTIVE AND PREFERENCE IN THE CHOICE OF METERED DOSE INHALER WITH SPACER VS NEBULIZER

Introduction Despite little evidence for its effectiveness, many physicians believe that delivery of medications for asthma exacerbation through nebulizer is more effective than via metered dose inhaler with spacer (MDIs). The objective is to evaluate physician's choice of method (MDIs vs nebulizer) for delivering bronchodilator therapy in children under 5. Methods A brief survey was sent was sent via electronic mail to a randomly selected group of primary care physicians and allergists. Results There was an 11.9 % (324/2718) total response rate. We divided the respondents into two groups. Group A comprised of primary care physicians and group B included practicing allergists. Group A: 30.8% (74/240) of respondents indicated nebulizer as their method of choice to deliver bronchodilator therapy during an asthma exacerbation. 32.9% (80/243) of respondents reported that nebulizer is an effective method. 51.3% (121/236) believe that delivering medication through nebulizer will produce increased adverse effects than MDIs. Group B: 51.2% (41/80) of respondents indicated, nebulizer as their method of choice. 58% (47/81) of respondents reported that nebulizer is an effective method. 64.1% (50/78) believe that delivering medication through nebulizer will produce increased adverse effects than MDIs. Conclusions Contrary to evidence-based recommendations, most allergists compared to primary physicians are not only prescribing nebulizer as their first choice for delivering bronchodilator therapy but, they also consider nebulizer to be an effective mode of delivery. As far as the safety is concerned, significantly more allergist believe that more side effects are associated with delivering bronchodilator therapy through nebulizer.