Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects
Bronchiectasis is a chronic lung condition which is characterised by recurrent chest infections, chronic sputum production and cough, and limited exercise tolerance. While bronchiectasis may be caused by various aetiologies, these features are shared by most patients with bronchiectasis regardless o...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2024-10-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/33/174/240087.full |
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| author | Arietta Spinou Annemarie L. Lee Brenda O'Neil Ana Oliveira Michal Shteinberg Beatriz Herrero-Cortina |
| author_facet | Arietta Spinou Annemarie L. Lee Brenda O'Neil Ana Oliveira Michal Shteinberg Beatriz Herrero-Cortina |
| author_sort | Arietta Spinou |
| collection | DOAJ |
| description | Bronchiectasis is a chronic lung condition which is characterised by recurrent chest infections, chronic sputum production and cough, and limited exercise tolerance. While bronchiectasis may be caused by various aetiologies, these features are shared by most patients with bronchiectasis regardless of the cause. This review consolidates the existing evidence on patient-managed interventions for adults with bronchiectasis, while also outlining areas for future research. Airway clearance techniques and hyperosmolar agents are key components of the bronchiectasis management and consistently recommended for clinical implementation. Questions around their prescription, such as optimal sequence of delivery, are still to be answered. Pulmonary rehabilitation and exercise are also recommended for patients with bronchiectasis. Relatively strong evidence underpins this recommendation during a clinically stable stage of the disease, although the role of pulmonary rehabilitation following an exacerbation is still unclear. Additionally, self-management programmes feature prominently in bronchiectasis treatment, yet the lack of consensus regarding their definition and outcomes presents hurdles to establishing a cohesive evidence base. Moreover, cough, a cardinal symptom of bronchiectasis, warrants closer examination. Although managing cough in bronchiectasis may initially appear risky, further research is necessary to ascertain whether strategies employed in other respiratory conditions can be safely and effectively adapted to bronchiectasis, particularly through identifying patient responder populations and criteria where cough may not enhance airway clearance efficacy and its control is needed. Overall, there is a growing recognition of the importance of patient-managed interventions in the bronchiectasis management. Efforts to improve research methodologies and increase research funding are needed to further advance our understanding of these interventions, and their role in optimising patient care and outcomes. |
| format | Article |
| id | doaj-art-d7491e77301f4cc38c943b5ae48fccb6 |
| institution | Kabale University |
| issn | 0905-9180 1600-0617 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj-art-d7491e77301f4cc38c943b5ae48fccb62025-01-02T11:42:02ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172024-10-013317410.1183/16000617.0087-20240087-2024Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospectsArietta Spinou0Annemarie L. Lee1Brenda O'Neil2Ana Oliveira3Michal Shteinberg4Beatriz Herrero-Cortina5 School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia School of Health Sciences, Ulster University, Coleraine, UK School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada Pulmonology Institute and Cystic Fibrosis Center, Carmel Medical Center and the Technion Israel Institute of Technology, the B. Rappaport Faculty of Medicine, Haifa, Israel Precision Medicine in Respiratory Diseases Group, Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain Bronchiectasis is a chronic lung condition which is characterised by recurrent chest infections, chronic sputum production and cough, and limited exercise tolerance. While bronchiectasis may be caused by various aetiologies, these features are shared by most patients with bronchiectasis regardless of the cause. This review consolidates the existing evidence on patient-managed interventions for adults with bronchiectasis, while also outlining areas for future research. Airway clearance techniques and hyperosmolar agents are key components of the bronchiectasis management and consistently recommended for clinical implementation. Questions around their prescription, such as optimal sequence of delivery, are still to be answered. Pulmonary rehabilitation and exercise are also recommended for patients with bronchiectasis. Relatively strong evidence underpins this recommendation during a clinically stable stage of the disease, although the role of pulmonary rehabilitation following an exacerbation is still unclear. Additionally, self-management programmes feature prominently in bronchiectasis treatment, yet the lack of consensus regarding their definition and outcomes presents hurdles to establishing a cohesive evidence base. Moreover, cough, a cardinal symptom of bronchiectasis, warrants closer examination. Although managing cough in bronchiectasis may initially appear risky, further research is necessary to ascertain whether strategies employed in other respiratory conditions can be safely and effectively adapted to bronchiectasis, particularly through identifying patient responder populations and criteria where cough may not enhance airway clearance efficacy and its control is needed. Overall, there is a growing recognition of the importance of patient-managed interventions in the bronchiectasis management. Efforts to improve research methodologies and increase research funding are needed to further advance our understanding of these interventions, and their role in optimising patient care and outcomes.http://err.ersjournals.com/content/33/174/240087.full |
| spellingShingle | Arietta Spinou Annemarie L. Lee Brenda O'Neil Ana Oliveira Michal Shteinberg Beatriz Herrero-Cortina Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects European Respiratory Review |
| title | Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects |
| title_full | Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects |
| title_fullStr | Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects |
| title_full_unstemmed | Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects |
| title_short | Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects |
| title_sort | patient managed interventions for adults with bronchiectasis evidence challenges and prospects |
| url | http://err.ersjournals.com/content/33/174/240087.full |
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