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Airway clearance techniques in bronchiectasis: Analysis from the United States Bronchiectasis and NTM Research Registry.
Chest. 2020 Jul 02 [Online ahead of print]Chest

Abstract

BACKGROUND

In patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies.

RESEARCH QUESTION

The primary objective was to describe differences in patients with bronchiectasis and productive cough who utilized ACTs and those who did not. Secondary objectives included assessment of bronchiectasis exacerbation frequency and change in pulmonary function at one-year follow-up.

STUDY DESIGN

and methods:Adult patients with bronchiectasis and productive cough in the United States Bronchiectasis and NTM Research Registry were included in the analyses. ACTs included the use of instrumental devices and manual techniques. Stratified analyses of demographic and clinical characteristics were performed by use of ACTs at baseline and follow-up. Association between ACT use and clinical outcomes was assessed using unadjusted and adjusted multinomial logistic regression models.

RESULTS

Of the overall study population (n=905), 59% utilized ACTs at baseline. A greater proportion of patients using ACTs at baseline and follow-up continuously had Pseudomonas aeruginosa (47% vs. 36%, p=0.021) and experienced an exacerbation (81% vs. 59%, p<0.0001) or hospitalization for pulmonary illness (32% vs. 22%, p=0.001) in the prior two years, compared to those not using ACTs. Fifty-eight percent of patients who utilized ACTs at baseline did not use ACTs at one-year follow-up. There was no significant change in pulmonary function for those that used ACTs at follow-up, compared to baseline. Patients using ACTs at baseline and follow-up had greater odds for experiencing exacerbations at follow-up compared to those not using ACTs.

Authors+Show Affiliations

New York University School of Medicine, New York, NY. Electronic address: Ashwin.basavaraj@nyulangone.org.Research, COPD Foundation, College of Public Health, Lexington, KY; University of Kentucky, College of Public Health, Lexington, KY.New York University School of Medicine, New York, NY.Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, MN.Department of Pulmonology, OHSU School of Medicine, Portland, OR.Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO.University of North Carolina at Chapel Hill, Chapel Hill, NC.Icahn School of Medicine, Mt. Sinai West and Mt. Sinai St Luke's Hospitals, Mt. Sinai, NY.Columbia College of Physicians and Surgeons, Center for Chest Disease, New York, NY.National Heart Lung and Blood Institute, NIH, Bethesda, MD.University of Texas at Tyler, Tyler, TX.Mayo Clinic Florida, Pulmonary and Critical Care, Jacksonville, FL.University of North Carolina at Chapel Hill, Chapel Hill, NC.Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, CT.University of North Carolina at Chapel Hill, Chapel Hill, NC.Georgetown University Medical Center, Washington, DC.National Heart Lung and Blood Institute, NIH, Bethesda, MD.University of Miami Miller School of Medicine, Miami, FL.University of Miami Miller School of Medicine, Miami, FL.Columbia College of Physicians and Surgeons, Center for Chest Disease, New York, NY.University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.Department of Pulmonology, OHSU School of Medicine, Portland, OR; Department of Infectious Disease, OHSU School of Medicine, Portland, OR.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32622820

Citation

Basavaraj, Ashwin, et al. "Airway Clearance Techniques in Bronchiectasis: Analysis From the United States Bronchiectasis and NTM Research Registry." Chest, 2020.
Basavaraj A, Choate R, Addrizzo-Harris D, et al. Airway clearance techniques in bronchiectasis: Analysis from the United States Bronchiectasis and NTM Research Registry. Chest. 2020.
Basavaraj, A., Choate, R., Addrizzo-Harris, D., Aksamit, T. R., Barker, A., Daley, C. L., Anne Daniels, M. L., Eden, E., DiMango, A., Fennelly, K., Griffith, D. E., Johnson, M. M., Knowles, M. R., Metersky, M. L., Noone, P. G., O'Donnell, A. E., Olivier, K. N., Salathe, M. A., Schmid, A., ... Winthrop, K. L. (2020). Airway clearance techniques in bronchiectasis: Analysis from the United States Bronchiectasis and NTM Research Registry. Chest. https://doi.org/10.1016/j.chest.2020.06.050
Basavaraj A, et al. Airway Clearance Techniques in Bronchiectasis: Analysis From the United States Bronchiectasis and NTM Research Registry. Chest. 2020 Jul 2; PubMed PMID: 32622820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway clearance techniques in bronchiectasis: Analysis from the United States Bronchiectasis and NTM Research Registry. AU - Basavaraj,Ashwin, AU - Choate,Radmila, AU - Addrizzo-Harris,Doreen, AU - Aksamit,Timothy R, AU - Barker,Alan, AU - Daley,Charles L, AU - Anne Daniels,M Leigh, AU - Eden,Edward, AU - DiMango,Angela, AU - Fennelly,Kevin, AU - Griffith,David E, AU - Johnson,Margaret M, AU - Knowles,Michael R, AU - Metersky,Mark L, AU - Noone,Peadar G, AU - O'Donnell,Anne E, AU - Olivier,Kenneth N, AU - Salathe,Matthias A, AU - Schmid,Andreas, AU - Thomashow,Byron, AU - Tino,Gregory, AU - Winthrop,Kevin L, Y1 - 2020/07/02/ PY - 2019/10/04/received PY - 2020/06/02/revised PY - 2020/06/04/accepted PY - 2020/7/6/entrez PY - 2020/7/6/pubmed PY - 2020/7/6/medline JF - Chest JO - Chest N2 - BACKGROUND: In patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies. RESEARCH QUESTION: The primary objective was to describe differences in patients with bronchiectasis and productive cough who utilized ACTs and those who did not. Secondary objectives included assessment of bronchiectasis exacerbation frequency and change in pulmonary function at one-year follow-up. STUDY DESIGN: and methods:Adult patients with bronchiectasis and productive cough in the United States Bronchiectasis and NTM Research Registry were included in the analyses. ACTs included the use of instrumental devices and manual techniques. Stratified analyses of demographic and clinical characteristics were performed by use of ACTs at baseline and follow-up. Association between ACT use and clinical outcomes was assessed using unadjusted and adjusted multinomial logistic regression models. RESULTS: Of the overall study population (n=905), 59% utilized ACTs at baseline. A greater proportion of patients using ACTs at baseline and follow-up continuously had Pseudomonas aeruginosa (47% vs. 36%, p=0.021) and experienced an exacerbation (81% vs. 59%, p<0.0001) or hospitalization for pulmonary illness (32% vs. 22%, p=0.001) in the prior two years, compared to those not using ACTs. Fifty-eight percent of patients who utilized ACTs at baseline did not use ACTs at one-year follow-up. There was no significant change in pulmonary function for those that used ACTs at follow-up, compared to baseline. Patients using ACTs at baseline and follow-up had greater odds for experiencing exacerbations at follow-up compared to those not using ACTs. SN - 1931-3543 UR - https://www.unboundmedicine.com/medline/citation/32622820/Airway_clearance_techniques_in_bronchiectasis:_Analysis_from_the_United_States_Bronchiectasis_and_NTM_Research_Registry L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(20)31847-X DB - PRIME DP - Unbound Medicine ER -
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