Publication:

Physician perspectives on spacer device usage, prescription patterns and clinical decision-making factors in the management of respiratory conditions: a nationwide, multicenter cross-sectional observational study

Background Pressurized metered-dose inhalers (pMDIs) are widely used for delivering bronchodilators and corticosteroids; however, their effectiveness is often compromised by poor inhalation techniques, leading to inadequate drug deposition in the lungs and suboptimal disease control. Spacer devices, including valved holding chambers (VHCs), are designed to overcome these challenges by improving aerosol delivery, reducing oropharyngeal deposition, and enhancing treatment adherence in patients with respiratory conditions. This survey aimed to assess physicians’ perspectives on the usage, prescription patterns, and decision-making factors associated with spacer devices in respiratory conditions.

Methods A cross-sectional survey was conducted among qualified medical practitioners using a structured questionnaire. Data on demographics, indications, and perceptions regarding spacer use were collected from 6,787 respondents.

Results Chest physicians constituted the largest respondent group (n=3,261). Nearly 80% of clinicians reported frequently or occasionally recommending spacer devices. Spacer use was most commonly associated with asthma maintenance therapy (n=5,214), acute asthma (n=3,861), and chronic obstructive pulmonary disease (COPD) (n=4,460). Key factors influencing prescription included disease severity, patient age, and the patient’s ability to use inhalers correctly. Major barriers identified were lack of patient/caregiver awareness, poor inhaler technique, and high device cost. Most respondents considered spacers more effective than nebulizers, and cylindrical spacers were the preferred design.

Conclusions The findings demonstrate widespread acceptance of spacer devices in respiratory care, particularly in asthma and COPD management. However, gaps in patient education, inhaler technique, and accessibility remain important barriers, highlighting the need for improved awareness initiatives and user-friendly spacer designs to optimize treatment outcomes.