TABLE 1

Statements included in the questionnaire for experts and percentage agreement

StatementAgreeDisagree
Is it safe for all people with bronchiectasis to travel?
  •   Most people with bronchiectasis can safely travel for vacation or business

96%4%
  •   It is best to avoid travelling during periods of unstable disease, such as during exacerbations

92%8%
  •   People with bronchiectasis should consult their healthcare providers and plan for travel

85%15%
  •   People with very severe bronchiectasis (e.g. candidate for lung transplantation, frequent hospitalisation) should be  advised not to travel abroad

73%27%
Planning travel: are there destinations and conditions that certain people with bronchiectasis should avoid?
  •   People with bronchiectasis should try to avoid travelling to places with high levels of air pollution

73%27%
  •   People with bronchiectasis should try to avoid travelling to places with a high prevalence of NTM (e.g. Hawaii, USA)

38%62%
  •   People with bronchiectasis should try to avoid travelling during influenza season

35%65%
  •   People with bronchiectasis should consult their healthcare professional regarding staying at high altitudes

85%15%
  •   Travelling to high-altitude destinations (above 3050 m/10 000 ft) should be avoided in people with bronchiectasis#

32%68%
  •   People with bronchiectasis should preferably travel to destinations with a nearby bronchiectasis centre

31%69%
What travel insurance should people with bronchiectasis acquire?
  •   Health insurance with coverage of deterioration of a chronic condition

100%
  •   Health insurance with coverage of hospital admission and emergency room visits#

100%
  •   Health insurance with coverage of repatriation#

68%32%
What medications and devices should people with bronchiectasis carry with them when travelling?
  •   When travelling, it is recommended that people with bronchiectasis should continue taking their regular  treatments and make arrangements to take enough medications and equipment for the duration of their travel

100%
  •   When travelling, people with bronchiectasis should consult their healthcare professional or respiratory  physiotherapist regarding possible alternatives to heavy or large equipment (e.g. nebulisers)

100%
  •   People with bronchiectasis who suffer frequent pulmonary exacerbations should consult their specialist regarding  carrying antibiotics to be used in case of a pulmonary exacerbation when travelling

100%
  •   Medications taken for travel should be properly stored according to manufacturer's recommendations (particularly  storage temperature, light exposure)

100%
  •   Electricity requirements (e.g. for a nebuliser) and cleaning instructions should be known prior to travelling and  proper adaptations, including checking batteries, should be planned

100%
How can people with bronchiectasis maintain regular treatments when in transport?
  •   It is advised that airway clearance and inhalations are performed while waiting at airports before and after flights.  This is best planned ahead and checked with the airport for the best place to do this

77%23%
  •   While it is not advised to take cough suppressants for bronchiectasis, it may be considered for long flights where  a cough may be disturbing to other passengers

35%65%
Do people with bronchiectasis need to prepare and carry certain documents?
  •   It is advised that patients with bronchiectasis carry documentation from the last clinic/hospitalisation visit,  translated into English and preferably also into the language of the country of destination

81%19%
  •   A document for travel may be prepared and should include: patient's health status, allergies, chronic bacterial  infections, regular medications and devices used regularly, recommended medications during exacerbation

100%
  •   It is advised that patients with bronchiectasis carry a translation of a disability card# (such as a European Union  disability parking card) if eligible and where available

84%16%
  •   When travelling in a guided tour, it is advised that people with bronchiectasis should notify the travel company of  their condition

69%31%
What are oxygen requirements on the flight and at the travel destination?
  •   Oxygen requirements during commercial flights should be predicted before flight

100%
  •   In people with an FEV1 <55% pred or oxygen saturation <93% at ambient air, a hypoxia inhalation test should be  performed

77%23%
  •   In people with FEV1 <1.5 L, a hypoxia inhalation test should be performed#

44%56%
  •   When planning travel to destinations between 2000 and 3050 m, considerations as for commercial flights should  be made

92%8%
How else can people with bronchiectasis be prepared to travel?
  •   It is recommended that people with bronchiectasis seek advice for travellers and follow recommended  immunisations for the destination

100%
  •   Recommended medications while travelling (such as for the prevention of malaria) should be checked for  interactions with regular treatments and with treatments during exacerbations

100%
  •   It is recommended that people with bronchiectasis should be stable prior to travelling, if symptoms typical for an  exacerbation develop shortly before travelling, treatment should be started and travel postponed if possible

96%4%
  •   People with severe bronchiectasis and chronic Pseudomonas sp. infection may be advised to receive treatment  with an intravenous antibiotic course shortly before travelling to prevent an exacerbation while away

50%50%
What kind of activities may people with bronchiectasis engage in while on holiday and what precautions are recommended?
  •   It is recommended that people with bronchiectasis should use sun protection while using medications that  increase photosensitivity (e.g. ciprofloxacin, doxycycline)

100%
  •   It is recommended that people with bronchiectasis take measures to avoid dehydration while in a hot climate

100%
  •   It is advised that people with bronchiectasis maintain general measures of hygiene to prevent cross-infection:  hand hygiene, wearing face masks in crowded places

88%12%
  •   It is recommended that all people with bronchiectasis refrain from SCUBA diving

35%65%
  •   It may be safe for people with bronchiectasis to SCUBA dive if they are asymptomatic (no sputum or shortness of  breath at the time of diving) and lung function is normal (FEV1 and peak expiratory flow should both be  >80% pred, FEV1/forced vital capacity >75%)

85%15%
  •   It is recommended that people with bronchiectasis should be aware of their own limitations to strenuous activities  and limit their participation in such activities accordingly. This refers to sports including hiking, swimming and  snorkelling, but also less strenuous activities such as short walks uphill and climbing stairs

96%4%
Where should people with bronchiectasis get help if they get sick while away?
  •   Prior to travel, people with bronchiectasis should be advised on increasing airway clearance if suffering an  exacerbation while away

96%4%
  •   Prior to travel, people with bronchiectasis should be advised when to take antibiotics, including a recommendation  for an oral antibiotic, dose and duration

100%
  •   People with bronchiectasis should be advised when and where to seek medical care at their destination

88%12%

NTM: nontuberculous mycobacteria; FEV1: forced expiratory volume in 1 s; SCUBA: self-contained underwater breathing apparatus; % pred: % predicted. #: 25 out of 26 responded; all other items had 26 responses.