Abstract
Non-cystic fibrosis bronchiectasis (NCFB) is a highly prevalent chronic respiratory disease with substantial burden to both patients and health care systems. Persons with NCFB (pwNCFB) are often given complex acute and chronic treatment regimens consisting of medications, airway clearance techniques and exercise. Accordingly, the high burden in NCFB has contributed to lower therapy adherence with estimates of 53% to medications, 41% to airway clearance and only 16% to all prescribed therapy. Consequent clinical outcomes from lower adherence include reduced quality of life, accelerated lung function decline and recurrent pulmonary exacerbations. In this narrative review, we explore the impact of multifactorial mechanisms underpinning adherence in NCFB and evaluate the available evidence towards interventions to improve uptake of therapy as demonstrated in other chronic respiratory diseases. A holistic approach, starting with a careful review of patient adherence at regular intervals, may increase the success of multidimensional therapeutic interventions in pwNCFB, but robust ongoing studies are an area of need in this population.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of Interest: Christina Thornton reports the following relationships outside the submitted work; grants or contracts received from Cystic Fibrosis Foundation Postdoctoral Funding; support for attending meetings and/or travel from Cystic Fibrosis Foundation Postdoctoral Funding.
Conflict of Interest: Ranjani Somayaji reports the following relationships outside the submitted work; contract research funding for trial in Calgary (SRI) and Grants for COVID clinical trial received from Sunnybrook Research Institute, University of Calgary, Calgary Health Foundation; clinical research funding received from CIHR, Cystic Fibrosis Foundation; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Vertex Pharmaceuticals (Cystic fibrosis education sessions); participation on a Data Safety Monitoring Board or Advisory Board for Oncovir DSMB.
Conflict of Interest: Rachel Lim has nothing to disclose.
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- Received July 8, 2022.
- Accepted August 17, 2022.
- Copyright ©The authors 2022
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