Introduction

British Thoracic Society (BTS) has standards of care for bronchiectasis, but it is unclear if these are adhered to. Royal Brompton Hospital (RBH) is the largest heart and lung centre in the UK. An audit was conducted, to assess adherence of the RBH physiotherapy services to national guidelines. Local use of outcome measures and airway clearance techniques (ACTs) were also reported. 

Methods

Review of the medical records of adults with bronchiectasis who attended the physiotherapy outpatient clinic during March-June 2022 and inpatients admitted March 2022-May 2022 were selected. Physiotherapy assessment and treatment was evaluated against BTS bronchiectasis guidelines for the management of non-cystic fibrosis bronchiectasis (2019), using a tool which incorporated local standards.

Results

17 outpatients and 26 inpatients were included: 85% females for both groups. Mean age (standard deviation) was 58.1 (17.4) and 64.7 (14.1) years, respectively. Mean (SD) length of hospital stay for inpatients was 15.66 (11.6) days. Compliance with guidelines for individualised ACTs was 95-100%. Items related to physical activity, disease education and management of non-respiratory complaints such as stress incontinence and musculoskeletal issues was variable (9-86%).

Visual analogue scale and Borg were common outcomes. Nebulisers, intermittent positive airway pressure and oscillatory-positive expiratory pressure were commonly used (Fig. 1).

Conclusions

Our results indicate high clinical compliance with individualised ACTs, but variable compliance with other national recommendations. Future work should investigate physiotherapy compliance nationally and mechanisms to improve adherence.