None listed
Conditions
Brief summary
International and national guidelines for bronchiectasis emphasise the importance of physiotherapy-led airway clearance therapy and exercise therapy, in the management of Bronchiectasis which affects approximately 263,000 people living with bronchiectasis in Australia Current physiotherapy intervention models in Australia are face-to-face inpatient or outpatient consultations. An alternative option is to provide physiotherapy through telehealth, however the feasibility and acceptance of telehealth physiotherapy has not been examined in people with bronchiectasis and the clinical effects of this intervention has not been determined. Our primary hypothesis is that an innovative model of telehealth physiotherapy will be feasible and acceptable to individuals with bronchiectasis and will be associated with a high level of satisfaction. Our secondary hypotheses are that a telehealth physiotherapy service will improve disease-specific quality of life and cough-related quality of life over 12 months, compared to no physiotherapy service; telehealth physiotherapy service will reduce the frequency of self-reported exacerbations compared to no physiotherapy service, and finally that participants receiving telehealth physiotherapy will outline a mix of views of their experiences and perceptions of the service provision.
Interventions
Participants will be offered up to four individualised telehealth sessions over 12 months, guided by minimum number recommended; the schedule will be determined by the clinician and participant, with each session approximately 90 minutes in duration. The same physiotherapist (with 20 years’ experience) will deliver the intervention to participants.
Physiotherapy sessions will consist of a personalised and pragmatic approach to assessment and treatment within each consultation to meet individual
Participants will be offered up to four individualised telehealth sessions over 12 months, guided by minimum number recommended; the schedule will be determined by the clinician and participant, with each session approximately 90 minutes in duration. The same physiotherapist (with 20 years’ experience) will deliver the intervention to participants. Physiotherapy sessions will consist of a personalised and pragmatic approach to assessment and treatment within each consultation to meet individual participants needs. Assessment and intervention will be specified using a fidelity checklist, and will include air way clearance technique prescription, including frequency and duration, with video resources accessed from Bronchiectasis Toolbox and Lung Foundation Australia websites. Recommendations for exercise therapy and self-management will be included as required. Airway clearance devices (OPEP devices – PARI, Aerobika) and exercise equipment (Theraband) will be provided to patients based on individual assessment of need. Advice for managing comorbidities which are amenable to physiotherapy interventions will be provided and referrals to services (Pain management, Falls and Balance, Pulmonary Rehabilitation) will be made as appropriate. Referrals to other healthcare professionals for managing other comorbidities (continence, sinusitis) will be completed. Overall, the focus of assessment and treatment interventions included in the sessions align with recommendations for physiotherapy practice. Attendance rates and compliance with intervention will be measured by the completion of a patient diary and by the treating physiotherapist. Fidelity will be assessed by the recording of treatment sessions and analysis by an independent investigator in line with a fidelity checklist
Sponsors
Dr Annemarie Lee
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults aged over 18 diagnosed with bronchiectasis according to high resolution computed tomography (HRCT) who have access to the internet and video conferencing facilities and understand spoken and written English.
Exclusion criteria
Primary diagnosis of a respiratory condition other than bronchiectasis such as cystic fibrosis, chronic obstructive pulmonary disease (smoking history of greater than 10 years or evidence of emphysema on HRCT), asthma (clinical diagnosis and reversibility >12%) or interstitial lung disease. Adults with bronchiectasis with an established relationship with a community-based or private practice physiotherapist for airway clearance therapy at the time of recruitment. Inclusion in drug trial measuring same outcome measures
Outcome results
None listed