COPD patients with severe disease and recent exacerbations more likely to continue chest wall oscillation therapy: Study

High-frequency chest wall oscillation (HFCWO) is a form of airway clearance therapy that has been available since the mid-1990s and is routinely used by patients suffering from retained pulmonary secretions. Patients with cystic fibrosis (CF), neuromuscular disease (NMD), and other disorders, including bronchiectasis (BE) and COPD (without BE), are commonly prescribed this therapy. Limited evidence exists describing HFCWO use in the BE population, its impact on long-term disease management, and the specific patient populations most likely to benefit from this therapy. This study sought to characterise the clinical characteristics of patients with BE who have documented use of HFCWO at baseline and 1-year follow-up. An analysis from a large national database registry of patients with BE was performed. Demographic and clinical characteristics of all patients receiving HFCWO therapy at baseline are reported. Patients were stratified into two groups based on continued or discontinued use of HFCWO therapy at 1-year follow-up.

Results: Over half (54.8 %) of patients who reported using HFCWO therapy had a Modified Bronchiectasis Severity Index (m-BSI) classified as severe, and the majority (81.4 %) experienced a worsening in the prior two years. Of patients with 1-year follow-up data, 73 % reported continued use of HFCWO. Compared to patients who discontinued therapy, these patients were more severe at baseline and at follow-up suggesting that patients with more severe disease are more likely to continue HFCWO therapy. Patients who have more severe disease and continue to experience exacerbations and hospitalizations are more likely to continue HFCWO therapy.

Reference:

Basavaraj A, Choate R, Becker BC, Aksamit TR, Metersky ML; Bronchiectasis and NTM Research Registry Investigators. The severity of bronchiectasis predicts use of and adherence to high-frequency chest wall oscillation therapy - Analysis from the United States Bronchiectasis and NTM research registry. Respir Med. 2024 Mar;223:107555. doi: 10.1016/j.rmed.2024.107555. Epub 2024 Feb 1. PMID: 38307319.