A group of researchers from Queen’s University in Belfast, United Kingdom, recently published a study aiming to determine the level of adherence to inhaled antibiotics, other respiratory medicines and airway clearance, and also to understand the association between adherence to any of these treatments and health outcomes in bronchiectasis. Bronchiectasis is a disease where there is a constant enlargement of parts of the airways in the lungs, leading to chronic cough with sputum production, shortness of breath, coughing up blood and chest pain, many times leading to lung infections. This disease can develop as part of a birth defect or as a result of injury or different diseases like tuberculosis, pneumonia and influenza.
In this research project, a total of 75 patients diagnosed with bronchiectasis and prescribed inhaled antibiotics for Pseudomonas aeruginosa infection were categorized as “adherent” to medication or airway clearance and enrolled into a one-year study.
The parameters measured included pulmonary exacerbations, defined as treatment with a new course of oral or intravenous antibiotics, lung function as measured by spirometry and Quality of Life Questionnaire-Bronchiectasis [QOL-B], all determined by regression analyses.
The results of this study indicated that 35 of the patients were adherent to inhaled antibiotics, 39 were adherent to other respiratory medicines and 31 were adherent to airway clearance, whereas 12 participants were adherent to all treatments. Additionally, patients’ adherent to inhaled antibiotics had significantly less exacerbations compared to non-adherent patients and adherence to airway clearance was associated with lower QOL-B Treatment Burden and Respiratory Symptoms domain scores. No associations between adherence to other respiratory medicines and the outcomes tested were verified.
This study allowed the researchers to conclude that treatment adherence is low in bronchiectasis and it plays a role in important health outcomes, namely pulmonary exacerbations. As a result, adherence should be measured as part of bronchiectasis management for future research strategies.
Resulting almost 1,000 annual deaths and an economic cost of $630 million per year in the US alone, studies covering multiple aspects of this condition can prove immensely important both for the patients and the general health care system.