https://doi.org/10.4081/monaldi.2021.1619
Home physiotherapists assisting follow-up treatment in cystic fibrosis: a multicenter observational study
Submitted: September 23, 2020
Accepted: January 11, 2021
Published: April 15, 2021
Accepted: January 11, 2021
Abstract Views: 897
PDF: 522
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
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.
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
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.
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