Frequent Disease Exacerbations Linked to Worse Quality of Life for Australian Bronchiectasis Patients, Study Shows

Frequent Disease Exacerbations Linked to Worse Quality of Life for Australian Bronchiectasis Patients, Study Shows

People with bronchiectasis who experience frequent exacerbations — three or more in the previous year — have a worse quality of life, and use more healthcare resources, according to a new study.

The study was the first data from the Australian Bronchiectasis Registry, the researchers said.

Titled “Australian adults with bronchiectasis: The first report from the Australian Bronchiectasis Registry,” the study was published in the journal Respiratory Medicine.

There have not been large scale, multi-center studies assessing Australians with bronchiectasis to date. Therefore, a group of Australian researchers in 2015 established the Australian Bronchiectasis Registry (ABR), a centralized database of people in the country with bronchiectasis.

The ABR was set up to provide a platform for ongoing collaborative research. It was designed to document the different characteristics of people with bronchiectasis, as a way of better planning patient management and delivery of health resources.

Additionally, as bronchiectasis is a diverse condition for which treatments are currently non-existent, there is a significant need to learn more about how to treat this patient population.

Now, a team led by researchers at the University of Sydney, in Australia, set out to describe the baseline characteristics of adult ABR participants. Their goal was to assess the impact of disease severity and exacerbations on quality of life (QoL).

Among the 799 adults enrolled in ABR from 14 Australian sites, baseline data was available for 589 (420 female, median age of 71 years). Most patients had either moderate or severe disease, according to Bronchiectasis Severity Index (BSI; 84%) and FACED (59%) composite scores, both validated measures of disease severity.

The majority (48%) had normal spirometry results, which is a common test used to assess how well the lungs work. Only 34% had airflow obstruction, or blockage of airflow from the lungs.

As expected, results showed that both disease severity scores — BSI and FACED — were correlated with QoL-Bronchiectasis scores. Essentially, researchers found that the more severe the disease is, the more likely the patient’s quality of life is impaired.

A total 23% of registrants were identified as frequent exacerbators, defined by having had three or more exacerbations in the past year. Frequent exacerbators had a worse quality of life, as determined by QoL-Bronchiectasis scores. They also underwent more hospitalizations compared with those who experienced less than three exacerbations in the previous year.

“The frequent exacerbation trait connotes poorer QoL and greater healthcare utilization,” the researchers said.

Overall, the study “demonstrates the negative influence of frequent exacerbations on QoL and healthcare utilization, and highlights a clinical phenotype that could be targeted,” the team concluded.

Additional studies, including validation of the commonly used disease severity scores — BSI and FACED — and the QoL-B questionnaire, are needed in Australian patients with bronchiectasis, the researchers said.

Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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5 comments

  1. This study did not prove much! People with more phelm are more likely to require more hospitalization.Who wouldn,t know that? How to stop the condition from getting worse or cure it would be something.As a patient with Bronchiectsis I have purchased my own oxygen concentrator so hopefully with my Doctors treatment plan drugs I don,t need hospitalization. I bought a used machine on Kijji shop around if others want to do the same.

  2. Jack Smith says:

    As an octogenarian I can state that I’ve suffered from bronchiectasis for about 65 years but it was only about 8 years ago that it was suggested that my condition stemmed from primary ciliary diskenesia, the in-detail investigations following-on from my increasing difficulties with expectoration. Postural drainage had proved increasingly ineffective whenever I had contracted a chest infection, the mucus becoming extremely viscous and extremely difficult to shift, with antibiotics seemingly less able to cope.
    Then I was advised to use a nebuliser whenever I have an exacerbation (infection) to inhale a 7% saline solution and this has proved to be a godsend in loosening the mucus. I take 250 mg azithromycin every two days and use an inhaler routinely, every day, DuoResp Spiromax (budesonide/formoterol.
    As I write, my condition is well controlled, which I put down to daily exercise, reasonable diet, the daily medication and – good luck! For others with this condition, I hope my experiences are helpful.

  3. Jennifer Williams says:

    Thank you for sharing your experiences. Since the end of December 2018 I have struggled to keep my Bronchiectasis under control. At beginning of May, 2019 I became quite unwell and have not recovered as yet. In Hindsight I needed to go to hospital, my specialist told me “people with Bronchiectasis have good and bad years, this is your bad year”.
    I don’t want to spend another year like this. I have taken your information and will discuss with my specialist. Thank you again.

  4. Hi, I am 71 years old, and have lived functionally with Bronchiectasis since 2007, but not “officially” diagnosed until 2011, when I was sent to National Jewish Health a respiratory disease research center in Denver Colorado.
    I had great doctors at home on Kaua’i, Hawai’i. I had received ample workup, two bronchoscopies, biopsies etc. Was told Bronchiectasis. Live with it.
    I worked full time as a Nurse Practitioner, long days, and a number of family deaths, crises, and issues. I told my patients it was just “allergies”. I coughed 2-3 times a day, for 45 + minutes. I used steroid inhalers, albuterol, and gallons of water to drink to keep mucus thin.
    I exercised, and got a German shepherd dog to drag me (literally) out of the house and make me walk.
    In 2011, almost 5 years after my initial dire pneumonia, I was diagnosed with Nocardiosis
    Otitidviscavum. A rare species of a common Nocardia mycobacterium that lives in the dirt and sometimes, tap water.
    A 5.5 month term of Bactria DS, 3 times a day, (gack) cured the infection, and the bronchiectasis was more manageable.
    I am extremely proactive about exercise and expanding my lung cage and. Muscles.
    I use inhalers.
    I discovered that using an over the counter Sudafed 12 daily, cuts down on secretions. You need to PUSH water, lemonade, tea, to flush your lungs and thin the secretions.
    The nebulizer trick really works, saline is your friend.
    At night I take 1/2 of a Benadryl 25 mg, antihistamine. No allergy related symptoms and a good night sleep.
    I never had respiratory reactions prior to the lung infection. Now my lungs are more sensitive, and I try to keep them from irritation, which is a setup for easy infection.
    I also support my immune system with healthy fruits and vegetables, vitamins, exercise,
    And Vitamin D.
    I use hand wipes, and take disinfection of public use items seriously. Shopping cart handles, bathroom doors, and any airplane travel…everything plastic around my seat gets disinfected, and especially the tray table (which has more e.coli organisms on it than a major study found in the bathrooms.). Don’t forget the seat belt buckle, the buttons to adjust the chair etc. and rental car steering wheels etc. Hotel door handles, telephones, light switches etc.
    I feel like Howard Hughes, but I don’t get sick. And I use respiratory masks in airports, boarding areas, and when I go to “Big Box” Department stores!!!
    It is some work, but I am well, healthy and can walk 7 miles. I actually was accepted and went to Oxford University’s summer writing program, all the way from Hawai’i. I wasn’t sick once. Your life is worth it. And it is better than being chained to a chair.
    Drink enough water, and you will have to go and pee, and then you will be up and moving!
    Cheers and Aloha🌺🙏🌈

  5. Helen Rawson says:

    Hi My name is Helen age 75.Dx with bronchiectasis in 2009 after enduring two years of negative chest x rays (total of 4) Dx found on cat scan. usually have about 3 exacerbations per year. This last recent (1 mo ago) was in hospital with pernicious cough, Have never expectorated any phlegm but have had 20 years of left nasal drainage, almost constant and clear .Have cold sx 365 days/yr. Doctors don’t seem to know much about dx. Last CXR showed bilateral atelectasis (base) shallow respirations.
    pulse ox is always normal (97-99). How come?? first hospital admit for this, am scared. Have had no teaching. thanks for the notes of patients. they give me ideas to help myself. could you keep me on your
    newsline? thank you I appreciate

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