RT Journal Article
SR Electronic
T1 Quality of life & clinical outcomes following referral to a specialist bronchiectasis service
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1922
VO 40
IS Suppl 56
A1 Jane Elliott
A1 Judy Ryan
A1 Karen Henderson
A1 Helen Gronlund
A1 Helen Barker
A1 Dennis Wat
A1 Nadia Shafi
A1 Jane French
A1 Floto Andres
A1 Floto Andres
A1 Charles Haworth
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1922.abstract
AB It is currently unclear whether referral of patients with bronchiectasis to a specialist centre improves quality of life (QoL) or clinical outcomes. We therefore evaluated these outcomes in consecutive new patients referred to our service in 2010. St George's Respiratory Questionnaires (SGRQ) were completed at their initial consultation and 12 months later. Clinical data were retrospectively collected from patient records.Of the 89 new patients, 44 (49%) completed both QoL assessments. Their mean age was 62.2±16 y and 21/44 were male. In the 12 months following referral, 27% (12) patients cultured P. aeruginosa, 25% (11) grew H. influenzae, 18% (8) S. pneumoniae, 11% (5) M. catarrhalis and 5% (2) NTM. 55% (24) patients grew no organism. There was no significant change in FEV1, however the average (median; IQR) number of infective exacerbations requiring antibiotics decreased from 5.0 (3–6) in the 12 months preceding referral to 1.0 (0 – 2) in the 12 months following initial assessment (p=0.0001). Analysis of SGRQ (where lower scores reflect a better QoL) at the beginning and end of the same period revealed significant decreases in overall scores from 44.0 (25.9-64.0) vs 36.8 (21.7-76.6; p=0.02), symptom scores from 61.4 (36.9-80.1) to 47.7 (26.3–70.3; p <0.003) and impact scores from 35.2 (19.9-54.0) to 28.4 (13.7–50.0; p=0.032). A common change to patient management was the prescription of long-term antibiotic prophylaxis which increased from 13.6% (6/44) patients at baseline to 50% (22/44) at follow up.We conclude that referral of patients to our specialist bronchiectasis service leads to significant improvements in quality of life and decreased infective exacerbations.