Cargando…

Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme

BACKGROUND AND OBJECTIVES: Cystic fibrosis (CF) is known to reduce lung function as measured by per cent predicted for the forced expiratory volume in the first second (ppFEV(1)) over time. Our paediatric CF programme demonstrated significant gaps in benchmarked ppFEV(1) predicted compared with the...

Descripción completa

Detalles Bibliográficos
Autores principales: Reamer, Courtney, O'Malley, Catherine, Nufer, Julie, Savant, Adrienne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368470/
https://www.ncbi.nlm.nih.gov/pubmed/32675178
http://dx.doi.org/10.1136/bmjoq-2019-000890
_version_ 1783560612485267456
author Reamer, Courtney
O'Malley, Catherine
Nufer, Julie
Savant, Adrienne
author_facet Reamer, Courtney
O'Malley, Catherine
Nufer, Julie
Savant, Adrienne
author_sort Reamer, Courtney
collection PubMed
description BACKGROUND AND OBJECTIVES: Cystic fibrosis (CF) is known to reduce lung function as measured by per cent predicted for the forced expiratory volume in the first second (ppFEV(1)) over time. Our paediatric CF programme demonstrated significant gaps in benchmarked ppFEV(1) predicted compared with the national median. Our objective was to assess whether the implementation of a modified Re-Education of Airway Clearance Techniques (REACT) programme could lead to an improvement in lung function as measured by ppFEV(1). METHODS: This 2-year prospective quality improvement study at Lurie Children’s CF Center for children aged >6 years used improvement methodology to implement a modified REACT programme. Outcome measures were assessed for our entire programme via the CF Foundation Patient Registry (CFFPR) and statistical process control. Comparisons were also made before and after REACT for outcome measures. RESULTS: By the end of implementation, monthly participation rate achieved 100%. Using CFFPR data and SPC, median ppFEV(1) increased by 3.9%, whereas only body mass index (BMI) as a secondary outcome increased. Comparison of pre and post REACT showed improvements in average ppFEV(1) (95% vs 96%, p<0.0001), FEF(25%−75%) (82% vs 83%, p=0.0590), rate of ppFEV1 decline (+2% vs −4%, p=0.0262) and BMI percentile (57% vs 60%, p<0.0001). CONCLUSIONS: Implementation of a modified REACT at Lurie Children’s paediatric CF programme led to an increase in ppFEV(1), FEF(25%−75%) and BMI percentile.
format Online
Article
Text
id pubmed-7368470
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-73684702020-07-22 Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme Reamer, Courtney O'Malley, Catherine Nufer, Julie Savant, Adrienne BMJ Open Qual Quality Improvement Report BACKGROUND AND OBJECTIVES: Cystic fibrosis (CF) is known to reduce lung function as measured by per cent predicted for the forced expiratory volume in the first second (ppFEV(1)) over time. Our paediatric CF programme demonstrated significant gaps in benchmarked ppFEV(1) predicted compared with the national median. Our objective was to assess whether the implementation of a modified Re-Education of Airway Clearance Techniques (REACT) programme could lead to an improvement in lung function as measured by ppFEV(1). METHODS: This 2-year prospective quality improvement study at Lurie Children’s CF Center for children aged >6 years used improvement methodology to implement a modified REACT programme. Outcome measures were assessed for our entire programme via the CF Foundation Patient Registry (CFFPR) and statistical process control. Comparisons were also made before and after REACT for outcome measures. RESULTS: By the end of implementation, monthly participation rate achieved 100%. Using CFFPR data and SPC, median ppFEV(1) increased by 3.9%, whereas only body mass index (BMI) as a secondary outcome increased. Comparison of pre and post REACT showed improvements in average ppFEV(1) (95% vs 96%, p<0.0001), FEF(25%−75%) (82% vs 83%, p=0.0590), rate of ppFEV1 decline (+2% vs −4%, p=0.0262) and BMI percentile (57% vs 60%, p<0.0001). CONCLUSIONS: Implementation of a modified REACT at Lurie Children’s paediatric CF programme led to an increase in ppFEV(1), FEF(25%−75%) and BMI percentile. BMJ Publishing Group 2020-07-16 /pmc/articles/PMC7368470/ /pubmed/32675178 http://dx.doi.org/10.1136/bmjoq-2019-000890 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Quality Improvement Report
Reamer, Courtney
O'Malley, Catherine
Nufer, Julie
Savant, Adrienne
Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title_full Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title_fullStr Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title_full_unstemmed Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title_short Improved outcomes in cystic fibrosis using modified Re-Education of Airway Clearance Technique (REACT) programme
title_sort improved outcomes in cystic fibrosis using modified re-education of airway clearance technique (react) programme
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368470/
https://www.ncbi.nlm.nih.gov/pubmed/32675178
http://dx.doi.org/10.1136/bmjoq-2019-000890
work_keys_str_mv AT reamercourtney improvedoutcomesincysticfibrosisusingmodifiedreeducationofairwayclearancetechniquereactprogramme
AT omalleycatherine improvedoutcomesincysticfibrosisusingmodifiedreeducationofairwayclearancetechniquereactprogramme
AT nuferjulie improvedoutcomesincysticfibrosisusingmodifiedreeducationofairwayclearancetechniquereactprogramme
AT savantadrienne improvedoutcomesincysticfibrosisusingmodifiedreeducationofairwayclearancetechniquereactprogramme