Highlights
- •Adherence to daily care by pediatric CF patients can be a challenge.
- •Increased daily ACT in school was associated with fewer pulmonary exacerbations.
- •Unique collaboration between CF care center and schools improved adherence.
Abstract
Background
Adherence to airway clearance therapy (ACT) in pediatric cystic fibrosis (CF) patients
is reported to be below 50% and inability to sustain daily care is linked to poor
health outcomes7,8,9. Through a collaboration between a CF care center and several schools, we hypothesized
that ACT completed at school by pediatric CF patients will improve lung function while
decreasing pulmonary exacerbations (PEx), days of antibiotics (abx) and hospitalizations.
Methods
This was a retrospective case-control study at a single CF care center consisting
of 50 CF patients age < 18 at time when data was recorded (2012–2020). The case group
used high-frequency chest wall oscillation or positive expiratory pressure devices
at school for at least 1 year after self-reported or physician identified inadequate
use at home. Lung function and measures of healthcare utilization were collected.
Results
In the case group (n = 14), paired t-tests showed that after initiation of ACT at school, there were significant
reductions in PEx requiring IV or PO abx (P = 0.010), total days of abx (P = 0.032), and visits to the CF care center (P = 0.037). There was no change in these outcomes in the matched control group (n = 36).
Conclusions
This is the first known study to highlight an initiative between a CF care center
and schools which utilized airway clearance devices at school to ensure pediatric
CF patients completed ACT. Through increased adherence, this relationship was associated
with improved health outcomes. Use of alternative strategies may help patients with
CF sustain adequate airway clearance.
Keywords
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Article info
Publication history
Published online: January 24, 2023
Accepted:
January 12,
2023
Received in revised form:
January 11,
2023
Received:
October 14,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
