1. In this context it is perhaps salutary to note that these unmet needs have been recognised since 1929 when a London general practitioner, Dr P W L Camps, wrote A note on the inhalation treatment of asthma!27
2. both national and international comparisons have shown an unreasonable variation in nebuliser treatment use and, by implication, unreasonable differences in clinical practice. In a UK regional survey,5 for instance, compressor use for domiciliary treatment varied between districts from four to 213 per 105 population. The European 1992 international asthma survey33 showed a similar variation in reports by physicians on their use of nebulisers for airway disease (fig 5). Such variations may represent, in part, varying access by patients and doctors to funding, but almost certainly they also reflect inconsistencies in the interpretation of present evidence about the suitability of nebuliser treatment. In contrast, in situations where there is a clearly restricted and detailed clinical indication and care has been taken to specify the details of nebuliser technique, they are likely to be approached in a much more uniform way. Examples are Table 4 Measuring the efficacy of nebuliser treatment;Similarly