Using Bronchiectasis Action Management Plans (BAMP) for children with bronchiectasis: Can it improve clinical care?

Abstract

Introduction/Aim: Bronchiectasis is a major contributor to chronic lung morbidity and mortality but remains a neglected disease in respiratory health. Currently, few high-level evidence-based management strategies are available for children with bronchiectasis. Thus, strategies to improve clinical outcomes associated with exacerbations are important and needed. In asthma and chronic obstructive pulmonary disease, use of personalized written management plans have been shown to improve clinical outcomes. We thus undertook a review of the current literature, to determine available evidence, to establish whether a personalised written bronchiectasis action management plan (BAMP) improves clinical outcomes in children with bronchiectasis. Methods: We conducted a review of the literature and planned to include all observational studies and randomised controlled trials (RCT) using parallel group design that compared the use of a BAMP versus a control group for children with bronchiectasis. Children were eligible if they were aged <19-years and had a high-resolution computed tomography diagnosis of bronchiectasis. Children were excluded if their bronchiectasis was related to cystic fibrosis or interstitial lung disease. Results: 43 potentially relevant articles were identified from our searches. 16 duplicates were removed, 27 articles were screened and 23 articles were excluded on title or abstract. Four full text articles were reviewed and subsequently excluded. No study (RCT or observational) met the inclusion criteria for this review. Conclusion: In the absence of published studies, we are unable to determine whether routine use of a written BAMP improves clinical outcomes for children. There is a need for high-quality RCTs to determine the effectiveness of a BAMP that includes a comparative group of usual care to assess improvement in clinical outcomes for children with bronchiectasis.L6350679322021-05-28 <br />