Outcomes of physiotherapy for people living with bronchiectasis: qualitative study to inform development of a core outcome set

Abstract

IntroductionEvidence of the effectiveness of physiotherapy for bronchiectasis is inconsistent, partly due to variation in the selection and reporting of outcomes in clinical trials. This qualitative study is a component of the development of a core outcome set (COS). The COS will identify a minimum group of outcomes for use in clinical trials of physiotherapy considering the views of researchers, patients, and clinicians. ObjectivesTo identify outcomes for use in physiotherapy research that are important to patients and physiotherapists and to explain their significance. MethodsSemi-structured interviews were conducted with adult patients with bronchiectasis who received physiotherapy, in addition to physiotherapists clinically involved in bronchiectasis care. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify, classify, and explain the significance of outcomes. Outcomes were mapped into the list created from literature review and classified into domains. ResultsWe interviewed 18 participants from four countries covering a range of experiences in different settings. Seventy outcomes were identified and grouped into 15 domains. Thirty-three outcomes were not previously reported in the literature. Thematic analysis revealed exacerbations, quality of life, use of healthcare resources, patient-reported symptoms, physical functioning, and sputum as the prominent themes reported by both patients and physiotherapists. ConclusionsThis qualitative study highlighted the importance of considering stakeholder perspectives when planning research trials. Outcomes identified will be used to inform the next phase of COS development. RegistrationThis study is part of the COS development project registered with the Core Outcome Measures in Effectiveness Trials initiative (COMET) https://www.comet-initiative.org/Studies/Details/1931 Contribution of the paper•The impact of physiotherapy in bronchiectasis is complex and multidimensional, generating numerous outcomes to be considered in research.•Some outcomes considered important to patients and physiotherapists may inform future trials as they differed from those reported in literature.•This study ensures that the views of patients and physiotherapists are considered in development of the core outcome set.