P29 How are we managing non-tuberculous mycobacteria pulmonary disease (NTM-PD)? Results from the first UK-wide survey of clinical practice

Abstract

<h3>Introduction and Objectives</h3> The prevalence of pulmonary non-tuberculous mycobacteria (NTM) isolates identified in the UK is increasing. We sought to ascertain the current NTM-pulmonary disease (NTM-PD)-related workload in the UK and the infrastructure in place to support this; and to compare reported NTM-PD management with recommendations outlined in national guidance. <h3>Methods</h3> A cross-sectional online survey on the diagnosis and management of NTM-PD was circulated between November 2020 and May 2021 via NTM Network UK, the British Thoracic Society and the British Infection Association to healthcare professionals across the UK who manage patients with NTM-PD. <h3>Results</h3> Data from 87 sites were analysed (including 4 paediatric and 12 cystic fibrosis centres). 76/87 (87%) of respondents were consultant physicians, of which 63% were adult respiratory consultants. NTM-related workload is considerable, with 62% of respondents seeing over six newly diagnosed NTM-PD patients each year, in addition to a further 10–20 patients already under follow-up. 41–60% of patients under review are commenced on treatment for NTM-PD. 68 (78%) sites manage NTM patients in TB clinic, whilst 8 have a dedicated NTM clinic. All respondents had access to bronchoscopy, and 66% also to induced sputum diagnostics. Support available from clinical nurse specialists and other allied healthcare professionals varied. 68% have input from TB specialist nurses whilst 14% receive no nursing support. 47% of respondents have support from physiotherapists, 41% from a pharmacist and 33% receive no allied healthcare support. Of the 66 respondents who do not work at a NTM tertiary referral centre, 42 (64%) do not receive external MDT support from one. 55% of clinicians do not provide or signpost NTM-PD patients to any patient information resources related to NTM-PD. <h3>Conclusions</h3> There is significant variation in how patients with NTM-PD are managed across the UK including existing infrastructure for NTM diagnosis and treatment, and a lack of standardised NTM care pathways. Opportunities to improve support to patients and clinicians include: 1) helping centres to set-up NTM-PD multi-disciplinary teams, 2) establishing regional networks and a national NTM-PD Clinical Advice Service and 3) enabling NTM patients to access relevant NTM information and support. Please refer to page A191 for declarations of interest related to this abstract.