Current and future management of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in the UK

Marc Lipman (Lead / Corresponding author), Joanne Cleverley, Tom Fardon, Besma Musaddaq, Daniel Peckham, Roald van der Laan, Paul Whitaker, Jacqui White

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Abstract

A rising number of non-tuberculous mycobacterial (NTM) isolates are being identified in UK clinical practice. There are many uncertainties around the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD), including its epidemiology, diagnosis, treatment and prevention. Regional variations in how patients with NTM-PD are managed reflects the lack of standardised pathways in the UK. Service optimisation and multidisciplinary working can improve the quality of care for patients with NTM-PD, including (1) better identification of patients at risk of NTM-PD and modification of risk factors where applicable; (2) standardisation of reference laboratory testing to offer clinicians access to accurate and prompt information on NTM species and drug sensitivities; (3) development of recognised specialist NTM nursing care; (4) standardisation of NTM-PD imaging strategies for monitoring of treatment and disease progression; (5) establishment of a hub-and-spoke model of care, including clear referral and management pathways, dedicated NTM-PD multidisciplinary teams, and long-term patient follow-up; (6) formation of clinical networks to link experts who manage diseases associated with NTM; (7) enabling patients to access relevant support groups that can provide information and support for their condition; and (8) development of NTM research groups to allow patient participation in clinical trials and to facilitate professional education.

Original languageEnglish
Article numbere000591
Pages (from-to)1-8
Number of pages8
JournalBMJ Open Respiratory Research
Volume7
Issue number1
Early online date21 Jun 2020
DOIs
Publication statusPublished - 21 Jun 2020

Keywords

  • bacterial infection
  • bronchiectasis
  • imaging/CT MRI
  • immunodeficiency
  • infection control
  • opportunist lung infections
  • rare lung diseases
  • respiratory Infection

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