Short-acting β<sub>2</sub> Agonist Inhalation Therapy for Asthma or Chronic Obstructive Pulmonary Disease with a High-flow Nasal Cannula in Japan - An Online Questionnaire Survey by the Japanese Respiratory Society, Japanese Society of In

Objective Short-acting β₂ agonists (SABAs) are key drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD). A high-flow nasal cannula (HFNC) is widely used for respiratory failure. Recently, a consensus statement on inhalation therapy with HFNC has been published. However, information regarding the real-world state of inhalation therapy practices in Japan is lacking. Methods An anonymous online questionnaire survey endorsed by three Japanese associations (the Japanese Respiratory Society, Japanese Society of Intensive Care Medicine, and Japanese Society of Respiratory Care Medicine) was administered from October to November 2023. Responses were stratified into three questions: Question A, "Do you routinely treat patients with asthma and COPD?" Question B "Do you routinely perform high-flow therapy?"; and Question C "How do you provide inhaled SABAs during high-flow therapy in patients with asthma or COPD?" Patients This questionnaire was distributed to all members of the three societies. Results Of the 567 participants who completed the questionnaire, 387 responded to all 3 questions. When a nebulizer was included in high-flow devices, the frequencies of using an ultrasonic nebulizer, jet, vibrating mesh, other, or not performing nebulization were 49.1%, 30.8%, 5.4%, 0.5%, and 14.2%, respectively; when a nebulizer was included in high-flow devices, these frequencies were 24.0%, 11.1%, 16.0%, 0%, and 48.9%, respectively. Conclusion Various techniques for inhalation therapy are being employed, revealing a discrepancy between current practices in Japan and the recommendations outlined in the consensus statement.