Peak flow meters

Peak flow meter

• Standard range, 60-800 litres/ minute (from £4.25)
• Low range, 30-400 litres/ minute (from £4.50)

Spacers

See the Inhaler technique reminder cards for information on the correct use of the devices included in the formulary. In children, metered dose inhaler (MDI) via spacer is the preferred method of delivery of beta₂ agonists or inhaled corticosteroids. Spacer devices may also be useful for adults and should be used whenever high dose inhaled corticosteroids (ICS) (see Inhaled Corticosteroid Dose Comparison in Asthma) are required to reduce the risk of oral candidiasis.

Aerochamber Plus (medium-volume spacer device)

• Standard device (blue) (£5.21 without mask, £8.69 with mask)
• Infant device (orange) (£8.69 with mask)
• Child device (yellow) (£8.69 with mask)

Notes

1. Prescribe by brand. Patient familiarity with one device is important; instructions for use vary between products and patient training is required.

Anti-Static Space Chamber Plus (medium-volume spacer device)

• Standard or compact spacer device (£4.53 without mask, £7.58 with small, medium or large mask)

Notes

1. Prescribe by brand. Patient familiarity with one device is important; instructions for use vary between products and patient training is required.

Volumatic (large-volume spacer device)

• Spacer (£3.88 without mask, £6.83 with paediatric mask)

Notes

1. Prescribe by brand. Patient familiarity with one device is important; instructions for use vary between products and patient training is required.

Haleraid is a device to place over pressurised (aerosol) inhalers to aid when strength in hands is impaired (e.g. in arthritis). Not prescribable on NHS.

Oscillating Positive Expiratory Pressure Devices

Oscillating Positive Expiratory Pressure Devices

• Devices include Acapella, Aerobika, Flutter.

Indication

• Management of cystic fibrosis

Notes

1. To be supplied by secondary care for the management of cystic fibrosis (NHS England commissioned)

Nebuliser diluent

Sodium chloride nebuliser solution

• Nebuliser solution 0.9% 2.5ml (£6.95 = 20 x 2.5ml)

Notes

1. See here for notes on nebulised therapy.

Hypertonic sodium chloride nebuliser solution

• Nebuliser solution 7% (click here for preferred brand)

Indication

• Management of cystic fibrosis patients with a forced vital capacity (FVC) of greater than 40% of predicted to improve pulmonary function

Dose

• By inhalation of nebulised solution, 4ml up to twice daily

Notes

1. Consultant initiated
2. Where a preferred brand is recommended for a particular presentation, prescribing by brand helps ensure cost-efficient use of local NHS resources (see preferred brand link above).

Continuous positive airway pressure (CPAP) devices

Continuous positive airway pressure is recommended as a treatment option for adults with symptomatic obstructive sleep apnoea/hypopnoea syndrome (OSAHS) in accordance with NICE TA139 (March 2008)

• The diagnosis and treatment of OSAHS, and the monitoring of the response, should be carried out by a specialist service with appropriately trained medical and support staff. For more information, please see NG202: Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (August 2021).
• CPAP devices are not suitable for prescribing in primary care, for referral information please see Sleep Apnoea CRG:
  • Southern Locality
  • Western Locality