Home physiotherapists assisting follow-up treatment in cystic fibrosis: a multicenter observational study

https://doi.org/10.4081/monaldi.2021.1619

Authors

  • Anna Brivio Cystic Fibrosis Centre and U.O.C. Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan , Italy.
  • Annalisa Orenti Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Epidemiology and Biometry G. A. Maccacaro, University of Milan, Italy. https://orcid.org/0000-0002-0932-2757
  • Mauro Barbisan UOS Fibrosi Cistica, Hospital S. Maria di Ca' Foncello, Treviso, Italy.
  • Paolo Buonpensiero Department of Translational Medical Sciences, Cystic Fibrosis Centre, Federico II University of Naples, Italy. https://orcid.org/0000-0002-4497-1904
  • Mirco Ros UOS Fibrosi Cistica, Hospital S. Maria di Ca' Foncello, Treviso, Italy.
  • Simone Gambazza | simone.gambazza@policlinico.mi.it Cystic Fibrosis Centre, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan; 3Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Epidemiology and Biometry G. A. Maccacaro, University of Milan , Italy. https://orcid.org/0000-0002-6225-2989

Abstract

Inhaled therapies are relatively simple and easy to be managed however ineffective use of aerosols when self-administered may occur. We described variation of the number of clinic visits, lung function and number of antibiotic courses performed over 12 months in participants with cystic fibrosis (CF), when supervised or not by physiotherapists (PTs) at home. Participants in 8 Italian CF centers with a prescription of dry-powder antibiotic choose whether to be supervised at home (PT-FU) or not (non-PT-FU), in adjunct to routine clinic visits. PTs assisted participants with their inhaled therapies regimen and reviewed the airway clearance program in use.  Mixed-effect regression models were fitted to evaluate the variation of selected endpoints over time. A total of 163 participants were included.  Lung function declined over time in both groups, at higher extent in the non-PT-FU group at 6 months (-1.8, 95%CI: -4.4 to 0.7 % predicted), without reaching statistical significance, whereas in the PT-FU group only, nearly one visit less was recorded (p=0.027). Regardless the type of supervision adopted, the number of antibiotic courses did not change compared to the previous year. We counted 19/90 (21.1%) drop-out in the PT-FU, double compared to the group followed up at the clinics (p=0.065). Participants under a course of an inhaled antibiotic therapy showed a 1-year decline in lung function, whereas only the group receiving home supervision counted nearly one visit less at the CF center, whose clinical relevance should be further discussed.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Castellani C, Duff AJA, Bell SC, et al. ECFS best practice guidelines: the 2018 revision. J Cyst Fibros 2018;17:153–78. DOI: https://doi.org/10.1016/j.jcf.2018.02.006

Weers J. Inhaled antimicrobial therapy - Barriers to effective treatment. Adv Drug Deliv Rev 2015;85:24–43. DOI: https://doi.org/10.1016/j.addr.2014.08.013

Ari A. Patient education and adherence to aerosol therapy. Respir Care 2015;60:941-55. DOI: https://doi.org/10.4187/respcare.03854

Sanchis J, Gich I, Pedersen S. Systematic review of errors in inhaler use: Has patient technique improved over time? Chest 2016;150:394–406. DOI: https://doi.org/10.1016/j.chest.2016.03.041

Gardenhire DS, Burnett D, Strickland S, Myers TR. A guide to aerosol delivery devices for respiratory therapists. Irving: American Association for Respiratory Care; 2017.

Gambazza S, Carta F, Brivio A, Colombo C. Aerosol delivery practice in Italian Cystic Fibrosis centres: a national survey. Arch Physiother 2016;6:1. DOI: https://doi.org/10.1186/s40945-016-0015-3

Conole D, Keating GM. Colistimethate sodium dry powder for inhalation: A review of its use in the treatment of chronic pseudomonas aeruginosa infection in patients with cystic fibrosis. Drugs 2014;74:377–87. DOI: https://doi.org/10.1007/s40265-014-0181-0

Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38. DOI: https://doi.org/10.1183/09031936.05.00034805

Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations. Eur Respir J 2012;40:1324–43. DOI: https://doi.org/10.1183/09031936.00080312

Cacciari E, Milani S, Balsamo A, et al. Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr). J Endocrinol Invest 2006;29:581–93. DOI: https://doi.org/10.1007/BF03344156

Lee TWR, Brownlee KG, Conway SP, et al. Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J Cyst Fibros 2003;2:29–34. DOI: https://doi.org/10.1016/S1569-1993(02)00141-8

O’Donohoe R, Fullen BM. Adherence of subjects with cystic fibrosis to their home program: A systematic review. Respir Care 2014;59:1731–46. DOI: https://doi.org/10.4187/respcare.02990

World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003. Available from: https://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf

Urquhart D, Sell Z, Dhouieb E, et al. Effects of a supervised, outpatient exercise and physiotherapy programme in children with cystic fibrosis. Pediatr Pulmonol 2012;47:1235-41. DOI: https://doi.org/10.1002/ppul.22587

Black R, Tallis M, Urquhart D, et al. Intensive out-patient physiotherapy-an approach to optimising lung health in childhood cystic fibrosis. Pediatr Pulmonol 2009;44:391-2.

Mercier A, Beaumesnil M, Chaillou E, et al. [Consultation pluridisciplinaire a domicile d’enfants mucoviscidosiques: experience d’un centre de ressources et de competences pour la mucoviscidose].[Article in French]. Arch Pediatr 2011;18:1340-1.

Conway S, Balfour-Lynn IM, De Rijcke K, et al. European cystic fibrosis society standards of care: Framework for the cystic fibrosis centre. J Cyst Fibros 2014;13:S3-22. DOI: https://doi.org/10.1016/j.jcf.2014.03.009

Tipping CJ, Scholes RL, Cox NS. A qualitative study of physiotherapy education for parents of toddlers with cystic fibrosis. J Cyst Fibros 2010;9:205-11. DOI: https://doi.org/10.1016/j.jcf.2010.02.003

Byrne NM, Hardy L. Community physiotherapy for children with cystic fibrosis: A family satisfaction survey. J Cyst Fibros 2005;4:123-7. DOI: https://doi.org/10.1016/j.jcf.2005.01.002

Ledger SJ, Owen E, Prasad SA, et al. A pilot outreach physiotherapy and dietetic quality improvement initiative reduces IV antibiotic requirements in children with moderate-severe cystic fibrosis. J Cyst Fibros 2013;12:766-72. DOI: https://doi.org/10.1016/j.jcf.2013.01.003

Finniss DG, Kaptchuk TJ, Miller F, Benedetti F. Biological, clinical, and ethical advances of placebo effects. Lancet 2010;375:686-95. DOI: https://doi.org/10.1016/S0140-6736(09)61706-2

Meissner K. Placebo responses on cardiovascular, gastrointestinal, and respiratory organ functions. Handb Exp Pharmacol 2014;225:183-203. DOI: https://doi.org/10.1007/978-3-662-44519-8_11

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-97. DOI: https://doi.org/10.1056/NEJMra050100

Downloads

Published
2021-04-15
Info
Issue
Section
Physiotherapy - Original Articles
Keywords:
physiotherapy, home visit, aerosol, cystic fibrosis
Statistics
  • Abstract views: 89

  • PDF: 49
How to Cite
Brivio, Anna, Annalisa Orenti, Mauro Barbisan, Paolo Buonpensiero, Mirco Ros, and Simone Gambazza. 2021. “Home Physiotherapists Assisting Follow-up Treatment in Cystic Fibrosis: A Multicenter Observational Study”. Monaldi Archives for Chest Disease 91 (2). https://doi.org/10.4081/monaldi.2021.1619.