Oscillating positive expiratory pressure (OPEP) device therapy in Canadian respiratory disease management: Review, care gaps and suggestion for use

Oscillating positive expiratory pressure (OPEP) devices are a non-pharmacologic therapy that can increase mobilization and elimination of airway mucus hypersecretions. In respiratory diseases such as chronic obstructive pulmonary disease, cystic fibrosis and others, mucus clearance can improve pulmonary mechanics and facilitate gas exchange, reduce breathlessness, prevent recurring infection, reduce exacerbations and hospitalization and improve quality of life. Several OPEP devices are available, although only a few have published evidence of efficacy, cost effectiveness and benefit to patients. We review the evidence and provide suggestions on inclusion of some OPEP devices in mucus clearance therapy regimens.