Abstract

Non-tuberculous mycobacterial pulmonary disease is on the rise globally. It is often missed, and causes significant morbidity and even mortality. Here, members of a clinical research network and a patient support group discuss some of the current key issues in NTM management.In addition to the need for research into epidemiology, immunology and treatment, we recommend greater use of patient and clinician networks to: (i) educate primary and secondary care clinicians to develop a high index of suspicion when investigating and treating at risk populations. (ii) promote a multidisciplinary team. (iii) promote shared patient-clinician decision making throughout care. (iv) incorporate use of patient self-report measures to assess progress and outcomes. (v) increase education of patients on their illness and its management. (vi) recruit patients into research projects and registries to improve the clinical evidence base. (vii) increase co-production of research with key stakeholders such as patients and their families, using expert patients and patient groups. (viii) understand more about the psychological, social and economic consequences of the disease.

Highlights

  • Increasing prevalenceLittle is known about the epidemiology, natural history or best management of non-tuberculous mycobacterial pulmonary disease (NTM-PD)

  • Progress requires collaboration between patients and clinicians; and as members of a clinical research network and a patient support group, we discuss some of the current key issues in NTM management, and make recommendations we believe are relevant in these areas

  • NTM-PD is usually seen in people with airways damage such as cystic fibrosis (CF), bronchiectasis or chronic obstructive pulmonary disease (COPD), or when normal lung epithelial ciliary action to clear sputum is impaired, or when immunity is lowered by age, immunosuppressive drugs, inhaled corticosteroids, or HIV infection

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Summary

Introduction

Increasing prevalenceLittle is known about the epidemiology, natural history or best management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Progress requires collaboration between patients and clinicians; and as members of a clinical research network and a patient support group, we discuss some of the current key issues in NTM management, and make recommendations we believe are relevant in these areas.

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