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Paediatric and adult bronchiectasis: monitoring, cross-infection, role of multi-disciplinary teams and self-management plans

Navaratnam, Vidya; Forrester, Douglas L.; Eg, Kah Peng; Chang, Anne B.

Authors

Vidya Navaratnam

Douglas L. Forrester

Kah Peng Eg

Anne B. Chang



Abstract

Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi; clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimise further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (FEV1 %predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with P. aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalisation. Other tools that are currently used in research settings such as health-related quality of life questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multi-disciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalised self-management plans are also important despite limited evidence it improves quality of life or frequency of exacerbations.

Citation

Navaratnam, V., Forrester, D. L., Eg, K. P., & Chang, A. B. (2018). Paediatric and adult bronchiectasis: monitoring, cross-infection, role of multi-disciplinary teams and self-management plans. Respirology, 24(2), 115-126. https://doi.org/10.1111/resp.13451

Journal Article Type Article
Acceptance Date Nov 5, 2018
Online Publication Date Nov 30, 2018
Publication Date Nov 30, 2018
Deposit Date Nov 5, 2018
Publicly Available Date Dec 1, 2019
Journal Respirology
Print ISSN 1323-7799
Electronic ISSN 1440-1843
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 24
Issue 2
Pages 115-126
DOI https://doi.org/10.1111/resp.13451
Keywords Non-cystic fibrosis bronchiectasis; Paediatric bronchiectasis; Cross-infection; Cross-transmission; Disease monitoring; Multi-disciplinary team; Self-management
Public URL https://nottingham-repository.worktribe.com/output/1225058
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/resp.13451
Additional Information This is the peer reviewed version of the article, which has been published in final form athttps://onlinelibrary.w...full/10.1111/resp.13451 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

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