Consensus Recommendations on Home Maintenance Nebulization with Focus on Obstructive Airway Diseases: An Update on Best Practices and Future Directions.

Asthma and chronic obstructive pulmonary disease (COPD) are obstructive airway diseases (OADs) that contribute significantly to the burden on healthcare systems in low- and middle-income countries like India.1,2 Inhaler therapy (primarily involving pressurized metered-dose inhalers and dry powder inhalers) remains the cornerstone of maintenance therapy; however, not all patients can use them effectively.3 Home maintenance nebulization (HMN) has been increasingly used as an alternative in appropriately identified patients, particularly those with advanced disease, physical or cognitive limitations, or suboptimal inspiratory flows. This expert consensus is an update from the 2017 recommendations, which provide evidence-informed recommendations on the use of HMN in OADs.4 By incorporating recent research findings and clinical expertise, the updated consensus addresses current gaps in knowledge, optimizes therapeutic protocols, and supports healthcare providers in delivering high-quality, patient-centered care. It is aimed at aiding clinicians involved in the management of OADs, including asthma and COPD, and evaluating the suitability of nebulization therapy as long-term maintenance treatment in home care settings.