Abstract
Background:
In bronchiectasis, due to cystic fibrosis (CF) and other causes, airways clearance is one of the mainstays of management. We conducted a systematic review on airways clearance using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough.
Methods:
The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?”. Populations selected were all patients with bronchiectasis due to cystic fibrosis or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those on standard therapy or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations and mortality.
Results:
In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these, there were no large randomized controlled trials that explored the impact of airways clearance on exacerbation rates, quality of life, hospitalizations or mortality.
Conclusions:
While the cough panel was not able to make recommendations, they have made consensus based suggestions and provided direction for future studies to fill the gaps in knowledge.
In bronchiectasis, due to cystic fibrosis (CF) and other causes, airways clearance is one of the mainstays of management. We conducted a systematic review on airways clearance using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough.
Methods:
The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?”. Populations selected were all patients with bronchiectasis due to cystic fibrosis or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those on standard therapy or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations and mortality.
Results:
In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these, there were no large randomized controlled trials that explored the impact of airways clearance on exacerbation rates, quality of life, hospitalizations or mortality.
Conclusions:
While the cough panel was not able to make recommendations, they have made consensus based suggestions and provided direction for future studies to fill the gaps in knowledge.
| Original language | English |
|---|---|
| Journal | Chest |
| Early online date | 17 Jan 2018 |
| DOIs | |
| Publication status | Early online date - 17 Jan 2018 |