Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)

Arietta Spinou; Beatriz Hererro-Cortina; Stefano Aliberti; Pieter C. Goeminne; Eva Polverino; Katerina Dimakou; Charles S. Haworth; Michael R. Loebinger; Anthony De Soyza; Montserrat Vendrell; Pierre Regis Burgel; Melissa McDonnell; Sivagurunathan Sutharsan; Sabina Škrgat; Luiz Maiz-Carro; Oriol Sibila; Daiana Stolz; Paula Kauppi; Apostolos Bossios; Adam T. Hill; Ian Clifton; Megan L. Crichton; Paul Walker; Rosario Menendez; Sermin Borecki; Dusanka Obradovic; Adam Nowinski; Adelina Amorim; Antoni Torres; Natalie Lorent; Tobias Welte; Francesco Blasi; Mateja Jankovic Makek; Michal Shteinberg; Wim Boersma; J. Stuart Elborn; James D. Chalmers; Felix C. Ringshausen; EMBARC Registry Collaborators

doi:10.1183/13993003.01689-2023

Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)

Arietta Spinou, Beatriz Hererro-Cortina, Stefano Aliberti, Pieter C. Goeminne, Eva Polverino, Katerina Dimakou, Charles S. Haworth, Michael R. Loebinger, Anthony De Soyza, Montserrat Vendrell, Pierre Regis Burgel, Melissa McDonnell, Sivagurunathan Sutharsan, Sabina Škrgat, Luiz Maiz-Carro, Oriol Sibila, Daiana Stolz, Paula Kauppi, Apostolos Bossios, Adam T. HillIan Clifton, Megan L. Crichton, Paul Walker, Rosario Menendez, Sermin Borecki, Dusanka Obradovic, Adam Nowinski, Adelina Amorim, Antoni Torres, Natalie Lorent, Tobias Welte, Francesco Blasi, Mateja Jankovic Makek, Michal Shteinberg, Wim Boersma, J. Stuart Elborn, James D. Chalmers, Felix C. Ringshausen, EMBARC Registry Collaborators

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

83 Downloads (Pure)

Abstract

BACKGROUND: International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis across different countries and factors influencing airway clearance use.

METHODS: This was a prospective observational study using data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) Registry between January 2015 and April 2022. Prespecified options for airway clearance management were recorded, including airway clearance techniques, devices and use of mucoactive drugs.

RESULTS: 16 723 people with bronchiectasis from 28 countries were included in the study. The mean age was 67 years (interquartile range 57-74 years, range 18-100 years) and 61% were female. 72% of the participants reported daily sputum expectoration and 52% (95% CI 51-53%) of all participants reported using regular airway clearance management. Active cycle of breathing technique was used by 28% of the participants and airway clearance devices by 16% of participants. The frequency of airway clearance management and techniques used varied significantly between different countries. Participants who used airway clearance management had greater disease severity and worse symptoms, including a higher daily sputum volume, compared to those who did not use it regularly. Mucoactive drugs were also more likely to be used in participants with more severe disease. Access to specialist respiratory physiotherapy was low throughout Europe, but particularly low in Eastern Europe.

CONCLUSIONS: Only a half of people with bronchiectasis in Europe use airway clearance management. Use of and access to devices, mucoactive drugs and specialist chest physiotherapy appears to be limited in many European countries.

Original language	English
Article number	2301689
Number of pages	15
Journal	The European respiratory journal
Volume	63
Issue number	6
DOIs	https://doi.org/10.1183/13993003.01689-2023
Publication status	Published - 6 Jun 2024

Keywords

Humans
Bronchiectasis/therapy
Female
Middle Aged
Male
Aged
Registries
Europe
Adult
Prospective Studies
Adolescent
Young Adult
Aged, 80 and over
Airway Management/methods
Respiratory Therapy/methods
Expectorants/therapeutic use

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

Access to Document

10.1183/13993003.01689-2023Licence: CC BY-NC

Final published versionFinal published version, 2.43 MBLicence: CC BY-NC

Cite this

Spinou, A., Hererro-Cortina, B., Aliberti, S., Goeminne, P. C., Polverino, E., Dimakou, K., Haworth, C. S., Loebinger, M. R., De Soyza, A., Vendrell, M., Burgel, P. R., McDonnell, M., Sutharsan, S., Škrgat, S., Maiz-Carro, L., Sibila, O., Stolz, D., Kauppi, P., Bossios, A., ... EMBARC Registry Collaborators (2024). Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC). The European respiratory journal, 63(6), Article 2301689. https://doi.org/10.1183/13993003.01689-2023

@article{d1a03363f11c448cafde826397aea5dd,

title = "Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)",

abstract = "BACKGROUND: International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis across different countries and factors influencing airway clearance use.METHODS: This was a prospective observational study using data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) Registry between January 2015 and April 2022. Prespecified options for airway clearance management were recorded, including airway clearance techniques, devices and use of mucoactive drugs.RESULTS: 16 723 people with bronchiectasis from 28 countries were included in the study. The mean age was 67 years (interquartile range 57-74 years, range 18-100 years) and 61% were female. 72% of the participants reported daily sputum expectoration and 52% (95% CI 51-53%) of all participants reported using regular airway clearance management. Active cycle of breathing technique was used by 28% of the participants and airway clearance devices by 16% of participants. The frequency of airway clearance management and techniques used varied significantly between different countries. Participants who used airway clearance management had greater disease severity and worse symptoms, including a higher daily sputum volume, compared to those who did not use it regularly. Mucoactive drugs were also more likely to be used in participants with more severe disease. Access to specialist respiratory physiotherapy was low throughout Europe, but particularly low in Eastern Europe.CONCLUSIONS: Only a half of people with bronchiectasis in Europe use airway clearance management. Use of and access to devices, mucoactive drugs and specialist chest physiotherapy appears to be limited in many European countries.",

keywords = "Humans, Bronchiectasis/therapy, Female, Middle Aged, Male, Aged, Registries, Europe, Adult, Prospective Studies, Adolescent, Young Adult, Aged, 80 and over, Airway Management/methods, Respiratory Therapy/methods, Expectorants/therapeutic use",

author = "Arietta Spinou and Beatriz Hererro-Cortina and Stefano Aliberti and Goeminne, {Pieter C.} and Eva Polverino and Katerina Dimakou and Haworth, {Charles S.} and Loebinger, {Michael R.} and {De Soyza}, Anthony and Montserrat Vendrell and Burgel, {Pierre Regis} and Melissa McDonnell and Sivagurunathan Sutharsan and Sabina {\v S}krgat and Luiz Maiz-Carro and Oriol Sibila and Daiana Stolz and Paula Kauppi and Apostolos Bossios and Hill, {Adam T.} and Ian Clifton and Crichton, {Megan L.} and Paul Walker and Rosario Menendez and Sermin Borecki and Dusanka Obradovic and Adam Nowinski and Adelina Amorim and Antoni Torres and Natalie Lorent and Tobias Welte and Francesco Blasi and {Jankovic Makek}, Mateja and Michal Shteinberg and Wim Boersma and Elborn, {J. Stuart} and Chalmers, {James D.} and Ringshausen, {Felix C.} and {EMBARC Registry Collaborators}",

note = "Copyright {\textcopyright}The authors 2024.",

year = "2024",

month = jun,

day = "6",

doi = "10.1183/13993003.01689-2023",

language = "English",

volume = "63",

journal = "The European respiratory journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

number = "6",

}

Spinou, A, Hererro-Cortina, B, Aliberti, S, Goeminne, PC, Polverino, E, Dimakou, K, Haworth, CS, Loebinger, MR, De Soyza, A, Vendrell, M, Burgel, PR, McDonnell, M, Sutharsan, S, Škrgat, S, Maiz-Carro, L, Sibila, O, Stolz, D, Kauppi, P, Bossios, A, Hill, AT, Clifton, I, Crichton, ML, Walker, P, Menendez, R, Borecki, S, Obradovic, D, Nowinski, A, Amorim, A, Torres, A, Lorent, N, Welte, T, Blasi, F, Jankovic Makek, M, Shteinberg, M, Boersma, W, Elborn, JS, Chalmers, JD, Ringshausen, FC & EMBARC Registry Collaborators 2024, 'Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)', The European respiratory journal, vol. 63, no. 6, 2301689. https://doi.org/10.1183/13993003.01689-2023

TY - JOUR

T1 - Airway clearance management in people with bronchiectasis

T2 - data from the European Bronchiectasis Registry (EMBARC)

AU - Spinou, Arietta

AU - Hererro-Cortina, Beatriz

AU - Aliberti, Stefano

AU - Goeminne, Pieter C.

AU - Polverino, Eva

AU - Dimakou, Katerina

AU - Haworth, Charles S.

AU - Loebinger, Michael R.

AU - De Soyza, Anthony

AU - Vendrell, Montserrat

AU - Burgel, Pierre Regis

AU - McDonnell, Melissa

AU - Sutharsan, Sivagurunathan

AU - Škrgat, Sabina

AU - Maiz-Carro, Luiz

AU - Sibila, Oriol

AU - Stolz, Daiana

AU - Kauppi, Paula

AU - Bossios, Apostolos

AU - Hill, Adam T.

AU - Clifton, Ian

AU - Crichton, Megan L.

AU - Walker, Paul

AU - Menendez, Rosario

AU - Borecki, Sermin

AU - Obradovic, Dusanka

AU - Nowinski, Adam

AU - Amorim, Adelina

AU - Torres, Antoni

AU - Lorent, Natalie

AU - Welte, Tobias

AU - Blasi, Francesco

AU - Jankovic Makek, Mateja

AU - Shteinberg, Michal

AU - Boersma, Wim

AU - Elborn, J. Stuart

AU - Chalmers, James D.

AU - Ringshausen, Felix C.

AU - EMBARC Registry Collaborators

PY - 2024/6/6

Y1 - 2024/6/6

N2 - BACKGROUND: International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis across different countries and factors influencing airway clearance use.METHODS: This was a prospective observational study using data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) Registry between January 2015 and April 2022. Prespecified options for airway clearance management were recorded, including airway clearance techniques, devices and use of mucoactive drugs.RESULTS: 16 723 people with bronchiectasis from 28 countries were included in the study. The mean age was 67 years (interquartile range 57-74 years, range 18-100 years) and 61% were female. 72% of the participants reported daily sputum expectoration and 52% (95% CI 51-53%) of all participants reported using regular airway clearance management. Active cycle of breathing technique was used by 28% of the participants and airway clearance devices by 16% of participants. The frequency of airway clearance management and techniques used varied significantly between different countries. Participants who used airway clearance management had greater disease severity and worse symptoms, including a higher daily sputum volume, compared to those who did not use it regularly. Mucoactive drugs were also more likely to be used in participants with more severe disease. Access to specialist respiratory physiotherapy was low throughout Europe, but particularly low in Eastern Europe.CONCLUSIONS: Only a half of people with bronchiectasis in Europe use airway clearance management. Use of and access to devices, mucoactive drugs and specialist chest physiotherapy appears to be limited in many European countries.

AB - BACKGROUND: International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis across different countries and factors influencing airway clearance use.METHODS: This was a prospective observational study using data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) Registry between January 2015 and April 2022. Prespecified options for airway clearance management were recorded, including airway clearance techniques, devices and use of mucoactive drugs.RESULTS: 16 723 people with bronchiectasis from 28 countries were included in the study. The mean age was 67 years (interquartile range 57-74 years, range 18-100 years) and 61% were female. 72% of the participants reported daily sputum expectoration and 52% (95% CI 51-53%) of all participants reported using regular airway clearance management. Active cycle of breathing technique was used by 28% of the participants and airway clearance devices by 16% of participants. The frequency of airway clearance management and techniques used varied significantly between different countries. Participants who used airway clearance management had greater disease severity and worse symptoms, including a higher daily sputum volume, compared to those who did not use it regularly. Mucoactive drugs were also more likely to be used in participants with more severe disease. Access to specialist respiratory physiotherapy was low throughout Europe, but particularly low in Eastern Europe.CONCLUSIONS: Only a half of people with bronchiectasis in Europe use airway clearance management. Use of and access to devices, mucoactive drugs and specialist chest physiotherapy appears to be limited in many European countries.

KW - Humans

KW - Bronchiectasis/therapy

KW - Female

KW - Middle Aged

KW - Male

KW - Aged

KW - Registries

KW - Europe

KW - Adult

KW - Prospective Studies

KW - Adolescent

KW - Young Adult

KW - Aged, 80 and over

KW - Airway Management/methods

KW - Respiratory Therapy/methods

KW - Expectorants/therapeutic use

UR - http://www.scopus.com/inward/record.url?scp=85195530480&partnerID=8YFLogxK

U2 - 10.1183/13993003.01689-2023

DO - 10.1183/13993003.01689-2023

M3 - Article

C2 - 38609097

SN - 0903-1936

VL - 63

JO - The European respiratory journal

JF - The European respiratory journal

IS - 6

M1 - 2301689

ER -

Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis (iABC) (Joint with 19 Partners)

Cite this

Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Projects

Inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis (iABC) (Joint with 19 Partners)

Cite this