Australian airway clearance services for adults with chronic lung conditions: A national survey

Abstract

Background Physiotherapy-led airway clearance interventions are indicated for some people with chronic lung conditions. This study describes Australian clinical models for the provision of adult airway clearance services. Methods This cross-sectional national study recruited public and private health care providers (excluding cystic fibrosis-specific services) identified by a review of websites. Providers were invited to complete an electronic 61-item survey with questions about airway clearance service context, referral demographics, service provision and program metrics. Data were reported descriptively with differences between metropolitan and non-metropolitan services explored with chi-square tests. Results Between October-December 2019, the survey was disseminated to 131 providers with 91 responses received (69% response rate; 87 (96%) public (34 metropolitan; 53 non-metropolitan) and 4 (4%) private). Intent (chronic condition self-management) and types of intervention provided (education, breathing techniques, exercise prescription) were common across all services. Geographic location was associated with differences in airway clearance service models (greater use of regular clinics, telephone/telehealth consultations and dedicated cardiorespiratory physiotherapists in metropolitan locations versus clients incurring service and device provision costs in non-metropolitan regions). Conclusions While similarities in airway clearance interventions exist, differences in service models may disadvantage people living with chronic lung conditions, especially in non-metropolitan regions of Australia.

Physiotherapy-led, community-based airway clearance services for people with chronic lung conditions: a retrospective descriptive evaluation of an existing model of care

“…This evaluation has described an operating ACS, which to our knowledge was the sole community-based outreach clinic for adults with chronic lung conditions and mucus hypersecretion in this region [ 30 ]. Airway clearance services in Australia have been described as ad hoc, understaffed, and inaccessible due to a lack of dedicated resources and space [ 18 , 30 ]. In contrast, the recognised needs of this health network were met with a stand-alone ACS that was easily accessed by consumers, many of whom described an improvement in their health-related quality of life because of their participation in the service.…”

“…This therapy may be applied as an intervention for individuals [ 13 ] or as a desirable component of pulmonary rehabilitation (PR) programs [ 14 ]; in hospital inpatient settings [ 15 , 16 ], or in outpatient clinics [ 17 ]. A survey of 91 Australian providers reported that airway clearance services (ACS) in non-acute settings lacked dedicated funding, resources, and staff, and in non-metropolitan areas, had fewer experienced clinicians, inadequate administrative support, and lower rates of device prescription at higher costs to clients [ 18 ]. Published accounts of ACS models of care in non-acute settings are rare, in contrast to the breadth and depth of information underpinning service provision and evaluation in PR [ 19 ] and specialised cystic fibrosis (CF) care [ 20 , 21 ].…”

Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia

“…10 Across the world, the perceived usefulness of MCDs in COPD management is lacking among HCPs. [11][12][13] In Saudi Arabia, guidelines for COPD care were established in 2014 but are still premature and need further amendments. 13 As recent evidence indicates, there are a number of challenges in formulating, structuring and expanding COPD care services in the kingdom, including a lack of awareness about national guidelines, a lack of hospital capacity and a lack of trained healthcare professionals.…”

“…Across the world, the perceived usefulness of MCDs in COPD management is lacking among HCPs 11–13. In Saudi Arabia, guidelines for COPD care were established in 2014 but are still premature and need further amendments 13.…”

Planning a ‘negligible risk’ national health service survey? Counting the cost and strategies for success: a short report

“…There is currently no register or government data that details the location and models of care for these services. This project contained two phases to address this gap: the first, a scoping review that aimed to report on the availability of web-based information about public and private airway clearance services in Australia (Cooper et al, 2019) and the second, a national survey of identified services to describe current models of care (Cooper et al, 2023).…”