I bought some for my smaller tanks, and love them. Like Draal5, I got them mostly because of the ladder. My larger tanks that have canister filters use simple DIY jobs, running directly into the canister syphon line.
note, you don't need to buy their refil packets, a sugar/water/bakers yeast or brewers yeast works just as well, if not better, and is a lot cheaper in the long run.
Place the bottle wherever you want to hide it, and let it run as long as it's producing bubbles at a decent rate I have a tendency to forget to refil the thing, and eventually when I'm looking at a tank, I'll notice that it's not producing any CO2 , so I'll refill it. My larger tanks are easier because I go with dual 2L bottles, and alternate one each week, whether they need it or not, and only change 50% of the liquid with new sugar water, and the yeast will just keep going. Cheaper like that.
edit: forgot about your question about holding the bottle. No, you don't have to hold it, unless you have a couple weeks of spare time and feel like it... DIY CO2 systems are basically set it and forget it, until it needs a refill.