1
|
Reychler G, Audag N, Prieur G, Poncin W, Contal O. [Guidelines for the management of airway mucus secretions by airway clearance techniques]. Rev Mal Respir 2024:S0761-8425(24)00225-0. [PMID: 39025771 DOI: 10.1016/j.rmr.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 07/20/2024]
Affiliation(s)
- G Reychler
- Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, université catholique de Louvain, Brussels, Belgique; Service de pneumologie, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Brussels, Belgique; Secteur de kinésithérapie et ergothérapie, cliniques universitaires Saint-Luc, Brussels, Belgique.
| | - N Audag
- Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, université catholique de Louvain, Brussels, Belgique; Service de pneumologie, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Brussels, Belgique; Secteur de kinésithérapie et ergothérapie, cliniques universitaires Saint-Luc, Brussels, Belgique
| | - G Prieur
- Physiotherapy Department, Le Havre Hospital, 76600 Le Havre, France
| | - W Poncin
- Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, université catholique de Louvain, Brussels, Belgique; Service de pneumologie, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Brussels, Belgique; Secteur de kinésithérapie et ergothérapie, cliniques universitaires Saint-Luc, Brussels, Belgique
| | - O Contal
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts of Western Switzerland, 1005 Lausanne, Suisse
| |
Collapse
|
2
|
Daynes E, Houchen-Wolloff L, Barradell AC, Greening NJ, Singh SJ. The Training to Improve Dyspnoea Study- Patient Experiences of Using a High Frequency Airway Oscillating Device. Int J Chron Obstruct Pulmon Dis 2024; 19:1345-1355. [PMID: 38887676 PMCID: PMC11182029 DOI: 10.2147/copd.s443186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/06/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction The High Frequency Airway Oscillating device (HFAO) was developed to help patients with COPD feel less breathless through flow resistive respiratory muscle training and fixed rate oscillations. Previous work has demonstrated that this device can improve inspiratory muscle strength over and above a sham device. Both groups improved their breathlessness and preserved clinical benefits though there were no statistically significant differences seen over and above the sham device. It is important to understand patient perceptions of using a device and how this may influence their treatment and therefore a qualitative analysis was conducted to understand participant experiences of a HFAO device. Methods This was an exploratory qualitative analysis involving participants recruited to the Training to Improve Dyspnoea (TIDe) study. Participants completed a satisfaction survey and were invited to take part in a focus group. Focus groups were conducted by a researcher independent to the randomised controlled trial. Data was analysed independently by two researchers using inductive thematic analysis, and themes/sub-themes were agreed jointly. Data is presented in themes and sub themes and triangulated with survey response data. Results Fourteen participants were recruited to two focus groups (71% male, mean [SD] age 64[9] years). The key themes were patient selection, device use, and investment. Patient selection explores the disease characteristics, emotional impact and management of care. Device use explores the device prescription and usage, routine and lifestyle and effectiveness. Investment covers accessibility, understanding, benefits vs participation and overall perceptions of the device. Conclusion This research demonstrates the complexity of device interventions and that key considerations should be given to patient selection, the device use itself and, the time and cost investment required for participants to successfully implement the device into daily life.
Collapse
Affiliation(s)
- Enya Daynes
- Leicester NIHR Biomedical Research Centre Respiratory, Glenfield Hospital, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Linzy Houchen-Wolloff
- Leicester NIHR Biomedical Research Centre Respiratory, Glenfield Hospital, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Amy C Barradell
- Leicester NIHR Biomedical Research Centre Respiratory, Glenfield Hospital, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Neil J Greening
- Leicester NIHR Biomedical Research Centre Respiratory, Glenfield Hospital, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sally J Singh
- Leicester NIHR Biomedical Research Centre Respiratory, Glenfield Hospital, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
3
|
Park J, Hong Y, Hong JY. Gender Differences in Antitussive Prescriptions for Chronic Cough in Korea. J Clin Med 2023; 12:7010. [PMID: 38002624 PMCID: PMC10672263 DOI: 10.3390/jcm12227010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Background: We investigated the differences in the characteristics and prognoses between the sexes of patients with chronic cough who were prescribed antitussive agents, using a Korean population-based database. Methods: Claims data from South Korea's Health Insurance Review and Assessment (HIRA) service were analyzed. This retrospective observational cohort study considered chronic cough patients aged 18 years and older who were consistently prescribed antitussive agents for more than 2 months between 1 January 2017 and 30 June 2019. Results: Among the 207,989 patients treated for chronic cough, the prevalence of unexplained cough was higher in women (men: 6.2% vs. women: 9.7%) and the prevalence of persistent cough was higher in men (men: 16.8% vs. women: 14.3%). The gap in the proportion of COPD, lung cancer, ILD, GERD, and TB between women and men were largest around the age range of 60-70 years. With the exception of those in their 60s and 70s, women were more likely to have chronic cough and persistent cough than men. Women were more likely to discontinue medication after treatment completion than men. Only 53.9% of patients discontinued cough medication for more than 6 months after treatment completion. Within 12 and 18 months, respectively, 8.9% and 11.9% of them revisited the hospital for chronic cough. Via Cox regression analysis, an age in the 60s or 70s and explained cough were independently associated with a higher risk of revisit for treatment. Conclusions: Among patients treated for chronic cough, there were distinct differences in cough characteristics and prescription status between men and women. Our data highlight the need for a new personalized treatment approach to chronic cough, taking into account the gender, age, and underlying diseases of patients. Further research is needed to determine whether appropriate underlying disease control and gender-specific treatment are effective for managing chronic cough.
Collapse
Affiliation(s)
- Jinkyeong Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea;
| | - Yoonki Hong
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon 24289, Republic of Korea;
| | - Ji Young Hong
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Chuncheon 24253, Republic of Korea
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| |
Collapse
|
4
|
Alghamdi SM, Alzahrani A, Alshahrani YM, Al Ruwaithi AA, Aldhahir AM, Alsulayyim AS, Siraj RA, Almansour AH, Alasmari AM, Alqahtani JS, Alanazi AM, Jaishi ST, Allehyani BA, Hopkinson NS. Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia. BMJ Open 2023; 13:e074849. [PMID: 37709318 PMCID: PMC10503362 DOI: 10.1136/bmjopen-2023-074849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known. DESIGN A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients. SETTING Saudi Arabia. PARTICIPANTS 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists. PRIMARY OUTCOME MEASURES Healthcare providers' level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia. RESULTS 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them. CONCLUSION Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients. TRIAL REGISTRATION NUMBER ISRCTN44651852.
Collapse
Affiliation(s)
- Saeed Mardy Alghamdi
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz Alzahrani
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yousef M Alshahrani
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulhadi A Al Ruwaithi
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | - Rayan A Siraj
- Department of Respiratory Therapy, King Faisal University, Al-Hasa, Saudi Arabia
| | - Abdulelah H Almansour
- Department of Family Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali M Alasmari
- Department of Respiratory Therapy, College of Medical Rehabilitation Services, Taibah University, Madinah, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah M Alanazi
- Department of Respiratory Care, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Siraj T Jaishi
- Al-Noor Specialist Hospital, Saudi Arabia Ministry of Health, Makkah, Saudi Arabia
| | | | | |
Collapse
|
5
|
Hamidfar R, Murris-Espin M, Mahot M, Abouly R, Gauchez H, Jacques S, Joffray E, Arnol N, Morin L, Leroy S, Borel JC. Feasibility of home initiation of an airway clearance device (SIMEOX) by telecare in people with non-cystic fibrosis bronchiectasis: a pilot study. BMJ Open Respir Res 2023; 10:e001722. [PMID: 37524523 PMCID: PMC10391802 DOI: 10.1136/bmjresp-2023-001722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Mucociliary clearance is a cornerstone of the management of people with non-cystic fibrosis bronchiectasis (NCFB). SIMEOX, an innovative device, could facilitate autonomous airway clearance, but its use requires specific training. We hypothesised that telecare would be an effective means to train people with NCFB in the handling of device and to monitor and promote device adherence. OBJECTIVES (1) To evaluate frequency of use of the SIMEOX for 10 weeks after telecare training. (2) To assess user satisfaction and clinical efficacy of the SIMEOX+telecare. METHODS Multicentre, prospective, pilot study in adults with NCFB. A SIMEOX was provided to each participant at inclusion. Physiotherapists performed telecare sessions the first 2 weeks (3-5 sessions) for device training and every 10 days to reinforce motivation and provide technical support. RESULTS 22 individuals were included, 21 analysed (38% male; mean±SD age 53±18 years; Bronchiectasis Severity Index 6.6±3.5). Fourteen participants (66.7%; 95% CI 43.1% to 84.5%) performed ≥3 SIMEOX sessions/week (self-reported adherence, primary outcome). Median (Q1; Q3) number of self-reported sessions/week for the whole group was 3.7 (1.8; 5.7). Adherence including web registration was 80.9%. At week 12, participant satisfaction rating was 9.0 (7.9; 10.0) on a 10-point visual analogue scale; respiratory function did not change but quality of life improved (COPD Assessment Test score -4.7, 95% CI -7.7 to -1.6, p=0.023; St Georges Respiratory Questionnaire -5.8, 95% CI -10.8 to -0.9, p=0.005). CONCLUSION Adherence to and satisfaction with the SIMEOX airway clearance device supported by telecare were high in people with NCFB. The clinical efficacy needs to be confirmed in a randomised controlled trial. TRIAL REGISTRATION NUMBER NCT04742270.
Collapse
Affiliation(s)
- Rebecca Hamidfar
- Service de Pneumologie-CRCM adulte Hôpital Michallon, Grenoble Alpes University Hospital, Grenoble, France
| | - Marlene Murris-Espin
- Service de Pneumologie-CRCM adulte Hôpital Larrey, CHU Toulouse, Toulouse, France
| | | | | | | | | | | | | | | | - Sylvie Leroy
- Service de Pneumologie-CRCM adulte Hôpital Pasteur, CHU Nice, Nice, France
| | | |
Collapse
|
6
|
Chen X, Li C, Zeng L, Rong T, Lin P, Wang Q, Guo Z, Long H, Zhong J. Comparative efficacy of different combinations of acapella, active cycle of breathing technique, and external diaphragmatic pacing in perioperative patients with lung cancer: a randomised controlled trial. BMC Cancer 2023; 23:282. [PMID: 36978035 PMCID: PMC10053339 DOI: 10.1186/s12885-023-10750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Acapella plus active cycle of breathing technique (ACBT), external diaphragm pacemaker (EDP) plus ACBT have been shown to facilitate the recovery of functional capacity and lung function in patients suffering from airway obstruction but the efficacy in perioperative patients with lung cancer has not been proven. METHODS We conducted a three-arm, prospective, randomized, assessor-blinded, controlled trial in patients with lung cancer who underwent thoracoscopic lobectomy or segmentectomy in the department of thoracic surgery, China. Patients were randomly assigned (1:1:1) to receive Acapella plus ACBT, EDP plus ACBT, or ACBT group (control group) using SAS software. The primary outcome was functional capacity, measured by the 6-minute walk test (6MWT). RESULTS We recruited 363 participants over 17 months: 123 assigned to the Acapella plus ACBT group, 119 to the EDP plus ACBT group, and 121 to the ACBT group. Statistically significant differences were noted for functional capacity between the EDP plus ACBT and control groups at each follow-up time (1-week follow-up: difference = 47.25 m, 95% CI, 31.56-62.93; P < 0.001; and 1-month follow-up: difference = 49.72 m, 95% CI, 34.04-65.41; P < 0.001), between the Acapella plus ACBT and control groups at postoperative week 1 (difference = 35.23 m, 95% CI, 19.30-51.16; P < 0.001) and postoperative month 1 (difference = 34.96 m, 95% CI, 19.03-50.89; P < 0.001), and between the EDP plus ACBT and Acapella plus ACBT groups at 1-month follow-up (difference = 14.76 m, 95% CI, 1.34-28.19; P = 0.0316). CONCLUSION EDP plus ACBT and Acapella plus ACBT significantly improved functional capacity and lung function in perioperative patients with lung cancer, compared with single-model ACBT, and the effects of EDP plus ACBT were clearly superior to those of other programs. TRIAL REGISTRATION The study was registered in the clinical trial database (clinicaltrials.gov) on June 4, 2021 (No. NCT04914624).
Collapse
Affiliation(s)
- Xiaoxue Chen
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Chuanzhen Li
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Linjuan Zeng
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Tiehua Rong
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Peng Lin
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Qinglin Wang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China
| | - Zhixing Guo
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China.
| | - Hao Long
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China.
| | - Jiudi Zhong
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangzhou, Guangdong, China.
| |
Collapse
|
7
|
Lewis A, Osadnik CR. Changing practice by changing pressures: a role for oscillating positive expiratory pressure in chronic obstructive pulmonary disease. Thorax 2023; 78:113-115. [PMID: 36167723 DOI: 10.1136/thorax-2022-219451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Adam Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Christian Robert Osadnik
- Department of Physiotherapy, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| |
Collapse
|