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Patient and caregiver perceptions of airway clearance methods used for cystic fibrosis
  • +7
  • Anthony Fischer,
  • Zoe Kienenberger,
  • Tyler O. Farber,
  • Mary E. Teresi,
  • Francesca Milavetz,
  • Sachinkumar Singh,
  • Katie Larson-Ode,
  • Theodosia Thoma,
  • Rebecca Weiner,
  • Kathryn R. Burlage
Anthony Fischer
The University of Iowa Stead Family Department of Pediatrics

Corresponding Author:anthony-fischer@uiowa.edu

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Zoe Kienenberger
The University of Iowa Stead Family Department of Pediatrics
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Tyler O. Farber
The University of Iowa Stead Family Department of Pediatrics
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Mary E. Teresi
The University of Iowa Stead Family Department of Pediatrics
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Francesca Milavetz
The University of Iowa Stead Family Department of Pediatrics
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Sachinkumar Singh
The University of Iowa Stead Family Department of Pediatrics
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Katie Larson-Ode
The University of Iowa Stead Family Department of Pediatrics
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Theodosia Thoma
The University of Iowa Stead Family Department of Pediatrics
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Rebecca Weiner
The University of Iowa Stead Family Department of Pediatrics
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Kathryn R. Burlage
The University of Iowa Department of Physical Therapy and Rehabilitation Sciences
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Abstract

Introduction: Cystic Fibrosis Foundation guidelines recommend people with CF perform daily airway clearance. This can be difficult for patients to complete, as some find it time consuming or uncomfortable. Data comparing airway clearance methods are limited. We surveyed patients and families to understand which methods are preferred and identify obstacles performing airway clearance. Methods: We designed a REDCap survey and enrolled participants in 2021. Respondents reported information on airway clearance usage, time commitment, and medication use. They rated airway clearance methods for effectiveness, comfort, time commitment, importance, and compatibility with other treatments. Analysis included descriptive statistics and clustering. Results: 60 respondents started and 52 completed the survey. The median patient age was 20 years. Respondents experienced a median of four airway clearance methods in their lifetime, including chest wall oscillation (vest, 92%), manual chest physical therapy (CPT, 88%), huff coughing (77%), and exercise (75%). Past 30-day use was highest for exercise (62%) and vest (57%). Time commitment was generally less than 2 hours daily. Of those eligible for CFTR modulators, 53% reported decreased time commitment to airway clearance after starting treatment. On a scale of 0-100, respondents rated CFTR modulators as their most important treatment (median 99.5), followed by exercise (88). Discussion: Patients and caregivers are familiar with several methods of airway clearance for CF. They report distinct strengths and limitations of each method. Exercise and vest are the most common methods of airway clearance. Use of CFTR modulators may reduce patient-reported time commitment to airway clearance.