Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance

CHEST Expert Panel Report

Adam T. Hill, Alan F. Barker, Donald C. Bolser, Paul Davenport, Belinda Ireland, Anne B. Chang, Stuart B. Mazzone, Lorcan McGarvey, Todd M. Adams, Kenneth W. Altman, Elie Azoulay, Surinder S. Birring, Fiona Blackhall, Louis Philippe Boulet, Christopher Brightling, Priscilla Callahan-Lyon, Terrie Cowley, Ali A. El Solh, Patricio Escalante, Stephen K. Field & 33 others Dina Fisher, Cynthia T. French, Peter Gibson, Susan M. Harding, Anthony Harnden, Richard S. Irwin, Peter J. Kahrilas, Joanne Kavanagh, Karina A. Keogh, Kefang Lai, Andrew P. Lane, Kaiser Lim, J. Mark Madison, Mark A. Malesker, Joshua P. Metlay, Alex Molasoitis, Abigail Moore, M. Hassan Murad, Mangala Narasimhan, Huong Q. Nguyen, Peter Newcombe, John Oppenheimer, Marcos I. Restrepo, Mark Rosen, Bruce Rubin, Jay H. Ryu, Sonal Singh, Maeve P. Smith, Susan M. Tarlo, Julie Turmel, Anne E. Vertigan, Gang Wang, Miles Weinberger

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods: The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?” Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results: In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions: Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.

Original languageEnglish (US)
Pages (from-to)986-993
Number of pages8
JournalChest
Volume153
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Bronchiectasis
Cough
Cystic Fibrosis
Fibrosis
Hospitalization
Quality of Life
Guidelines
Therapeutics
Mortality
Population
Randomized Controlled Trials
Placebos

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Hill, A. T., Barker, A. F., Bolser, D. C., Davenport, P., Ireland, B., Chang, A. B., ... Weinberger, M. (2018). Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report. Chest, 153(4), 986-993. https://doi.org/10.1016/j.chest.2018.01.014

Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance : CHEST Expert Panel Report. / Hill, Adam T.; Barker, Alan F.; Bolser, Donald C.; Davenport, Paul; Ireland, Belinda; Chang, Anne B.; Mazzone, Stuart B.; McGarvey, Lorcan; Adams, Todd M.; Altman, Kenneth W.; Azoulay, Elie; Birring, Surinder S.; Blackhall, Fiona; Boulet, Louis Philippe; Brightling, Christopher; Callahan-Lyon, Priscilla; Cowley, Terrie; El Solh, Ali A.; Escalante, Patricio; Field, Stephen K.; Fisher, Dina; French, Cynthia T.; Gibson, Peter; Harding, Susan M.; Harnden, Anthony; Irwin, Richard S.; Kahrilas, Peter J.; Kavanagh, Joanne; Keogh, Karina A.; Lai, Kefang; Lane, Andrew P.; Lim, Kaiser; Madison, J. Mark; Malesker, Mark A.; Metlay, Joshua P.; Molasoitis, Alex; Moore, Abigail; Murad, M. Hassan; Narasimhan, Mangala; Nguyen, Huong Q.; Newcombe, Peter; Oppenheimer, John; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Singh, Sonal; Smith, Maeve P.; Tarlo, Susan M.; Turmel, Julie; Vertigan, Anne E.; Wang, Gang; Weinberger, Miles.

In: Chest, Vol. 153, No. 4, 01.04.2018, p. 986-993.

Research output: Contribution to journalArticle

Hill, AT, Barker, AF, Bolser, DC, Davenport, P, Ireland, B, Chang, AB, Mazzone, SB, McGarvey, L, Adams, TM, Altman, KW, Azoulay, E, Birring, SS, Blackhall, F, Boulet, LP, Brightling, C, Callahan-Lyon, P, Cowley, T, El Solh, AA, Escalante, P, Field, SK, Fisher, D, French, CT, Gibson, P, Harding, SM, Harnden, A, Irwin, RS, Kahrilas, PJ, Kavanagh, J, Keogh, KA, Lai, K, Lane, AP, Lim, K, Madison, JM, Malesker, MA, Metlay, JP, Molasoitis, A, Moore, A, Murad, MH, Narasimhan, M, Nguyen, HQ, Newcombe, P, Oppenheimer, J, Restrepo, MI, Rosen, M, Rubin, B, Ryu, JH, Singh, S, Smith, MP, Tarlo, SM, Turmel, J, Vertigan, AE, Wang, G & Weinberger, M 2018, 'Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report', Chest, vol. 153, no. 4, pp. 986-993. https://doi.org/10.1016/j.chest.2018.01.014
Hill, Adam T. ; Barker, Alan F. ; Bolser, Donald C. ; Davenport, Paul ; Ireland, Belinda ; Chang, Anne B. ; Mazzone, Stuart B. ; McGarvey, Lorcan ; Adams, Todd M. ; Altman, Kenneth W. ; Azoulay, Elie ; Birring, Surinder S. ; Blackhall, Fiona ; Boulet, Louis Philippe ; Brightling, Christopher ; Callahan-Lyon, Priscilla ; Cowley, Terrie ; El Solh, Ali A. ; Escalante, Patricio ; Field, Stephen K. ; Fisher, Dina ; French, Cynthia T. ; Gibson, Peter ; Harding, Susan M. ; Harnden, Anthony ; Irwin, Richard S. ; Kahrilas, Peter J. ; Kavanagh, Joanne ; Keogh, Karina A. ; Lai, Kefang ; Lane, Andrew P. ; Lim, Kaiser ; Madison, J. Mark ; Malesker, Mark A. ; Metlay, Joshua P. ; Molasoitis, Alex ; Moore, Abigail ; Murad, M. Hassan ; Narasimhan, Mangala ; Nguyen, Huong Q. ; Newcombe, Peter ; Oppenheimer, John ; Restrepo, Marcos I. ; Rosen, Mark ; Rubin, Bruce ; Ryu, Jay H. ; Singh, Sonal ; Smith, Maeve P. ; Tarlo, Susan M. ; Turmel, Julie ; Vertigan, Anne E. ; Wang, Gang ; Weinberger, Miles. / Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance : CHEST Expert Panel Report. In: Chest. 2018 ; Vol. 153, No. 4. pp. 986-993.
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title = "Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report",
abstract = "Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods: The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?” Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results: In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions: Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.",
author = "Hill, {Adam T.} and Barker, {Alan F.} and Bolser, {Donald C.} and Paul Davenport and Belinda Ireland and Chang, {Anne B.} and Mazzone, {Stuart B.} and Lorcan McGarvey and Adams, {Todd M.} and Altman, {Kenneth W.} and Elie Azoulay and Birring, {Surinder S.} and Fiona Blackhall and Boulet, {Louis Philippe} and Christopher Brightling and Priscilla Callahan-Lyon and Terrie Cowley and {El Solh}, {Ali A.} and Patricio Escalante and Field, {Stephen K.} and Dina Fisher and French, {Cynthia T.} and Peter Gibson and Harding, {Susan M.} and Anthony Harnden and Irwin, {Richard S.} and Kahrilas, {Peter J.} and Joanne Kavanagh and Keogh, {Karina A.} and Kefang Lai and Lane, {Andrew P.} and Kaiser Lim and Madison, {J. Mark} and Malesker, {Mark A.} and Metlay, {Joshua P.} and Alex Molasoitis and Abigail Moore and Murad, {M. Hassan} and Mangala Narasimhan and Nguyen, {Huong Q.} and Peter Newcombe and John Oppenheimer and Restrepo, {Marcos I.} and Mark Rosen and Bruce Rubin and Ryu, {Jay H.} and Sonal Singh and Smith, {Maeve P.} and Tarlo, {Susan M.} and Julie Turmel and Vertigan, {Anne E.} and Gang Wang and Miles Weinberger",
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T1 - Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance

T2 - CHEST Expert Panel Report

AU - Hill, Adam T.

AU - Barker, Alan F.

AU - Bolser, Donald C.

AU - Davenport, Paul

AU - Ireland, Belinda

AU - Chang, Anne B.

AU - Mazzone, Stuart B.

AU - McGarvey, Lorcan

AU - Adams, Todd M.

AU - Altman, Kenneth W.

AU - Azoulay, Elie

AU - Birring, Surinder S.

AU - Blackhall, Fiona

AU - Boulet, Louis Philippe

AU - Brightling, Christopher

AU - Callahan-Lyon, Priscilla

AU - Cowley, Terrie

AU - El Solh, Ali A.

AU - Escalante, Patricio

AU - Field, Stephen K.

AU - Fisher, Dina

AU - French, Cynthia T.

AU - Gibson, Peter

AU - Harding, Susan M.

AU - Harnden, Anthony

AU - Irwin, Richard S.

AU - Kahrilas, Peter J.

AU - Kavanagh, Joanne

AU - Keogh, Karina A.

AU - Lai, Kefang

AU - Lane, Andrew P.

AU - Lim, Kaiser

AU - Madison, J. Mark

AU - Malesker, Mark A.

AU - Metlay, Joshua P.

AU - Molasoitis, Alex

AU - Moore, Abigail

AU - Murad, M. Hassan

AU - Narasimhan, Mangala

AU - Nguyen, Huong Q.

AU - Newcombe, Peter

AU - Oppenheimer, John

AU - Restrepo, Marcos I.

AU - Rosen, Mark

AU - Rubin, Bruce

AU - Ryu, Jay H.

AU - Singh, Sonal

AU - Smith, Maeve P.

AU - Tarlo, Susan M.

AU - Turmel, Julie

AU - Vertigan, Anne E.

AU - Wang, Gang

AU - Weinberger, Miles

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods: The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?” Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results: In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions: Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.

AB - Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods: The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?” Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results: In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions: Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.

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