Airway clearance treatments in bronchiectasis: feasibility of linking survey results to registry data and a survey of patients’ and physiotherapists’ practices

Abstract

Background and objectiveThere are limited data on airway clearance treatment (ACT) practices. This study aimed (i) to assess the feasibility of collecting online surveys on ACTs from patients and physiotherapists and linking the patient survey data to outcome data in the Bronch-UK/EMBARC Registry; (ii) to assess the association between ACT practices and outcome data and (iii) to ascertain the factors affecting physiotherapist ACT practices.MethodsSurvey methodology was used to collect data from (i) patients with bronchiectasis and (ii) physiotherapists in Northern Ireland (NI). Associations between patient survey data and linked Bronch-UK/EMBARC Registry patient outcome data were explored.ResultsIt was feasible to conduct an online survey with patients with bronchiectasis and link the data to Bronch-UK/EMBARC Registry. 13% of patients did not perform ACTs. ACTs were used more often by patients who were symptomatic/had more severe disease compared to those with milder symptoms/disease. Patients used ACTs when they were symptomatic rather than as a preventative management strategy. Physiotherapists generally followed the bronchiectasis guidelines, using the stepwise approach to management.ConclusionOur survey provided information about the feasibility of linking online survey and patient registry data. This study provides up to date information on ACT practice throughout the course of the disease trajectory, as well as insight into the implementation of bronchiectasis guidelines by physiotherapists. Future work should explore how to optimise ACT data collection to maximise the use of real world ACT data in bronchiectasis research, and inform priority ACT research questions.

Digital technologies in bronchiectasis physiotherapy services: a survey of patients and physiotherapists in a UK centre

“…Airway clearance techniques (ACTs) are central in the management strategy for patients with bronchiectasis (1). In our recent survey of 205 patients with bronchiectasis in Northern Ireland in the UK we described current practices for ACT in patients with bronchiectasis from the patient and physiotherapist perspective (2). We reported that physiotherapists are generally following the bronchiectasis guidelines and using the stepwise approach to management.…”

Airway clearance technique in the modern era of bronchiectasis management

“…In this issue of ERJ Open Research , M c L eese et al . [ 13 ] analysed the status quo of ACTs by performing online surveys among patients with bronchiectasis (consistent with the outcome data in the Bronch-UK/EMBARC Registry) and physiotherapists. The authors evaluated the feasibility of collecting ACT practice data online, the association between patient-reported ACT practice data and the outcomes in the Bronch-UK/EMBARC Registry, and the factors affecting physiotherapists’ decisions on initiating ACTs.…”

“…A strength of the study design was that M c L eese et al . [ 13 ] quantified the dose of ACTs into three grades: low, medium and high dose. Patients performing ACTs (particularly high-dose ACTs) were more elderly and had more severe bronchiectasis (evidenced by the greater frequency of exacerbations in the previous year and lower quality of life).…”

“…The study findings by M c L eese et al . [ 13 ] have provided an important basis for researchers and clinicians to better understand the status quo and improve the outcome of ACT treatment in patients with bronchiectasis.…”

“…A core mission for physiotherapists is to establish a follow-up plan and provide expert guidance to better implement the ACTs. The study findings by MCLEESE et al [13] have provided an important basis for researchers and clinicians to better understand the status quo and improve the outcome of ACT treatment in patients with bronchiectasis.…”