Developing a core outcome set for physiotherapy management in adults with bronchiectasis: the COS-PHyBE study

Bronchiectasis is a chronic respiratory disease that is characterised by airways widening and recurrent infections, resulting in episodes of chronic cough, sputum expectoration, and dyspnoea. This leads to deterioration in daily function and quality of life and recurrent hospital admissions. The prevalence and mortality related to bronchiectasis is increasing worldwide and it has a large economic burden on healthcare systems. A combined approach of medical, physiotherapy, and self-management is currently recommended to manage symptoms and prevent exacerbations. Physiotherapy for bronchiectasis aims to decrease accumulation of sputum, and improve exercise capacity and fitness thus decreasing dyspnoea, and improving daily function. Evidence to support physiotherapy in bronchiectasis is currently lacking. This is partly because of heterogeneity and poor reporting of outcomes in available studies.

This study aims to develop a core outcome set for physiotherapy research in adults with bronchiectasis. Core outcome set (COS) is the minimum acceptable group of outcomes that should be used in clinical trials for a specific condition. An agreed COS decreases research waste by improving consistency and reporting of valuable outcomes, studies then can be more easily synthesised in systematic reviews and inform guidelines that enhance physiotherapy evidence-based practice in bronchiectasis.

This project will use the published Core Outcome Measures in Effectiveness Trials Initiative (COMET) guidelines, and will involve both Core Outcome Set (COS) and Core Measurement Set (CMS) development.

Contributors

Principle investigator: Hayat Hamzeh
Supervisor: Prof. Sally Spencer
Supervisor: Dr. Carol Kelly
Faculty of Health, Social Care and Medicine, Edge Hill University, Lancashire, UK

Further Study Information

Current Stage: Ongoing
Date: January 2021 - January 2024
Funding source(s): This doctoral research is supported by a studentship from Edge Hill University, UK.


Health Area

Disease Category: Lungs & airways

Disease Name: Bronchiectasis

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Physiotherapy

Stakeholders Involved

- Clinical experts
- Consumers (patients)
- Patient/ support group representatives
- Researchers
- Service providers
- Service users

Study Type

- COS for clinical trials or clinical research
- Recommendations for outcome measures (measurement/how)

Method(s)

- Consensus meeting
- Delphi process
- Interview
- Systematic review

COS development
1. Systematic review of current outcomes and outcome measurement instruments in physiotherapy for adult bronchiectasis studies.
2. Qualitative interview study with bronchiectasis patients and physiotherapists to identify additional important outcomes from stakeholders’ point of view.
3. Delphi study to establish consensus on COS for bronchiectasis, involving researchers, patients, and clinicians.
4. Consensus meeting to agree final COS based on the results of the Delphi study.

CMS development
1. Systematic review to evaluate psychometric properties for outcome measurement instruments used for the established COS outcomes.
2. Delphi study to establish consensus on CMS for bronchiectasis, involving researchers, patients, and clinicians.