Solomon George M, Barker Alan F, McSpiritt Elizabeth, Marikovics Sonja, Quittner Alexandra L
University of Alabama at Birmingham, Birmingham, Alabama.
Oregon Health and Science University, Portland, Oregon.
ATS Sch. 2023 Jan 30;4(1):76-86. doi: 10.34197/ats-scholar.2022-0061IN. eCollection 2023 Mar.
Airway clearance therapies (ACTs) are recommended as an integral part of the management of non-cystic fibrosis bronchiectasis (BE) to prevent inflammation, mucus accumulation, and infection that occur because of ineffective secretion clearance. Adherence to ACTs is low, in part because of perceived burden and a lack of standardization of education and training programs for patients. Poor adherence is associated with more frequent exacerbations, worse health outcomes, and worse quality of life. Structured educational programs increase adherence to ACT among people with cystic fibrosis and may show similar results for people with BE.
This pilot study evaluated the feasibility, clinical utility, sustainability, and expert opinions of this educational program addressing gaps in ACT knowledge and skills in people with BE.
The Individual Management of Patient Airway Clearance Therapy- Bronchiectasis (IMPACT BE) was implemented in nine BE centers with 100 patients. Qualitative and quantitative data were collected from patients and providers.
The IMPACT BE program demonstrated good uptake in a clinic setting by multidisciplinary team members, with improvements in medical teams' evaluation of their ability to provide education to patients. All healthcare teams indicated that this program could become a sustainable part of their clinic. Qualitative responses from patients indicated the program was comprehensive and easy to use.
In this pilot study, IMPACT BE was found to be useful in teaching airway clearance to people with BE. The open-access toolkit was well received by both patients and a diverse array of providers in a clinic setting.
气道廓清治疗（ACTs）被推荐作为非囊性纤维化支气管扩张症（BE）管理的一个组成部分，以预防因分泌物清除无效而发生的炎症、黏液积聚和感染。ACTs的依从性较低，部分原因是患者感觉到的负担以及针对患者的教育和培训计划缺乏标准化。依从性差与更频繁的病情加重、更差的健康结局和更低的生活质量相关。结构化教育计划可提高囊性纤维化患者对ACT的依从性，对BE患者可能也会有类似结果。
这项试点研究评估了该教育计划在解决BE患者ACT知识和技能差距方面的可行性、临床实用性、可持续性及专家意见。
在9个BE中心对100名患者实施了患者气道廓清治疗个体化管理 - 支气管扩张症（IMPACT BE）计划。从患者和医护人员处收集了定性和定量数据。
IMPACT BE计划在临床环境中得到了多学科团队成员的良好接受，医疗团队对其向患者提供教育能力的评估有所改善。所有医疗团队均表示该计划可成为其诊所可持续的一部分。患者的定性反馈表明该计划全面且易于使用。
在这项试点研究中，发现IMPACT BE对向BE患者传授气道廓清方法很有用。该开放获取工具包在临床环境中受到了患者和各类医护人员的好评。
