New guidelines conclude all aerosol therapy devices equally...( New evidence-based guidelines for the s...),Health

New evidence-based guidelines for the selection of aerosol medication devices conclude that health-care providers should avoid basing device selection exclusively on device efficacy. Instead, the choice should be based on other patient-related factors. All aerosolized medication delivery systems are equally effective when used properly. Aerosolized medication is typically used to treat patients with respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD).

For the first time, the American College of Chest Physicians (ACCP) and the American College of Allergy, Asthma, & Immunology (ACAAI) have developed joint evidence-based guidelines for the selection of aerosol delivery devices. Published in the January issue of CHEST, the peer-reviewed journal of the ACCP, the guidelines were developed by an international panel of pulmonary experts and provide recommendations on overall device selection and device selection for several commonly encountered clinical settings.

Based on a systematic review of pertinent randomized, controlled trials (RCT), panel members compared metered-dose inhalers (MDIs) with or without spacers/holding chambers, dry powder inhalers, and nebulizers, delivering both bronchodilators (beta2-agonists) and inhaled corticosteroids in order to determine the best recommendations for device selection. To achieve a fair comparison, RCTs were selected only if the same drug was used in the different delivery systems tested. Due to the limited number of published RCTs of inhaled corticosteroids, the majority of the studies reviewed and selected were RCTs of bronchodilators. Overall, guidelines state that aerosolized medication delivery systems, when used with comparable drug doses, provide equivalent efficacy and, therefore, recommend that health-care providers not base device selection exclusively on device efficacy but rather on several criteria, including device availability; cost; convenience; and the pati
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Contact: Jennifer Stawarz
jstawarz@chestnet.org
847-498-8306
American College of Chest Physicians
10-Jan-2005

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