Patient and caregiver perceptions of airway clearance methods used for
cystic fibrosis
Abstract
Introduction: Cystic Fibrosis Foundation guidelines recommend
people with CF perform daily airway clearance. This can be difficult for
patients to complete, as some find it time consuming or uncomfortable.
Data comparing airway clearance methods are limited. We surveyed
patients and families to understand which methods are preferred and
identify obstacles performing airway clearance. Methods: We
designed a REDCap survey and enrolled participants in 2021. Respondents
reported information on airway clearance usage, time commitment, and
medication use. They rated airway clearance methods for effectiveness,
comfort, time commitment, importance, and compatibility with other
treatments. Analysis included descriptive statistics and clustering.
Results: 60 respondents started and 52 completed the survey.
The median patient age was 20 years. Respondents experienced a median of
four airway clearance methods in their lifetime, including chest wall
oscillation (vest, 92%), manual chest physical therapy (CPT, 88%),
huff coughing (77%), and exercise (75%). Past 30-day use was highest
for exercise (62%) and vest (57%). Time commitment was generally less
than 2 hours daily. Of those eligible for CFTR modulators, 53% reported
decreased time commitment to airway clearance after starting treatment.
On a scale of 0-100, respondents rated CFTR modulators as their most
important treatment (median 99.5), followed by exercise (88).
Discussion: Patients and caregivers are familiar with several
methods of airway clearance for CF. They report distinct strengths and
limitations of each method. Exercise and vest are the most common
methods of airway clearance. Use of CFTR modulators may reduce
patient-reported time commitment to airway clearance.