Patients’ and caregivers’ perceptions toward nebulization therapy for COPD: The first quantitative survey done in India

Background: There is paucity of Indian data on nebulizer usage, patients’ and caregivers’ attitudes towards nebulization in COPD. Objective: Survey aimed to evaluate Indian adult male and female patients’ and caregivers’ attitudes and perceptions towards nebulization for COPD management. Methods: Survey was conducted from July-August 2019 among 103 COPD patients [>40 years] receiving home nebulization (>3 weeks), and their caregivers, to assess usage, satisfaction, perceived benefits and concerns with nebulizers. Results: Overall, 54% patients were on nebulizer regimen for >8 weeks (occasionally/daily) and 27% patients used nebulizers daily for home maintenance. Key benefits of nebulizers perceived by patients were easier breathing (93%), ease of use (89%) and fewer doctor visits (86%) while caregivers cited reduced hospitalization (76%), easier breathing (75%) and better control on overall symptoms (73%). Patients perceived short-term duration of effect (61%), social embarrassment (54%) and device being bulky and noisy (50%) as major concerns for nebulizers; while caregivers cited multiple uses per day (45%) and social embarrassment (43%). Among patients prescribed inhaler therapy earlier, 72% felt nebulizers gave long-term relief compared to inhalers. 61% patients opined that benefits with nebulizers outweighed the inconvenience associated with its use. Overall 99% patients reported satisfaction with nebulizers. Conclusion: This first of its kind survey demonstrated that majority of COPD patients and their caregivers were satisfied with nebulizers, with reported benefits of reduced hospitalization, better symptom control and ease of use.