Nebulizer Cleaning Practices and Adherence to Nebulized Therapies in People With Cystic Fibrosis When Traveling

BACKGROUND: Nebulized therapies form an important component of treatment in people with cystic fibrosis (CF). It is important for people with CF to continue to take their nebulized medications when traveling.

METHODS: A self-completing anonymous questionnaire was developed, as part of a quality improvement project, to support people with CF educational needs when traveling. The questionnaire was prepared to gain an insight into (1) adherence to nebulized therapies when traveling and (2) nebulizer cleaning and disinfection practices while traveling. Polar questions (yes/no response) were mainly employed as well as free text and closed questions.

RESULTS: There were 68 respondents to the survey, including 31 males, 33 females, and 4 respondents who did not enter their sex. Respondents who declared their age (n = 63) ranged from 17–71 y (median = 30 y; with 94% of respondents in age range 20–39 y). When traveling, 38% (25/66) of respondents indicated that nebulized therapy was not performed during travel. The most common method of nebulizer maintenance while traveling was washing with soap and water (43%), followed by boiling water (18%), as well as the employment of 5 other methods of nebulizer maintenance. Some respondents (2%) indicated that they did not perform any method of nebulizer maintenance while traveling until they returned home.

CONCLUSIONS: This study identified that nebulizer care and hygiene are less than optimal when traveling as well as identifying a worrying trend of taking a “nebulizer vacation.” People with CF need to be aware of risks to their health in being nonadherent with their nebulized medication(s) while traveling as well as risks of acquiring a new pathogen through suboptimal cleaning/disinfection/drying management of their nebulizer. CF multidisciplinary teams should emphasize the importance of sustaining nebulized treatments when traveling and practicing effective nebulizer washing, disinfection, and drying procedures.

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