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.