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Patient-Centered Research Priorities for Pulmonary Nontuberculous Mycobacteria (NTM) Infection. An NTM Research
Emily Henkle1, Timothy Aksamit2, Alan Barker3
11 School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon.
Abstract:
Nontuberculous mycobacteria (NTM) cause an increasingly important chronic and debilitating lung disease in older adults. Diagnosis is often delayed, although awareness among clinicians and patients is increasing. When necessary, treatment often lasts 18-24 months and consists of three or four antibiotics that can have serious side effects. Relapses are common and commonly require resumption of prolonged therapy. Given the need for improved diagnostic techniques and clinical trials to identify new therapies or to improve existing therapies, a group of North American clinicians and researchers formed the NTM Research Consortium (NTMRC) in 2014. The NTMRC recognized the importance of including the patient voice in determining research priorities for NTM. In November 2015, patients, caregivers, patient advocates, clinical experts, and researchers gathered for a 1-day meeting in Portland, Oregon funded by the Patient-Centered Outcomes Research Institute. The meeting goal was to define patient-centered research priorities for NTM lung infections. Patients expressed frustration with the number of people who have endured years of missed diagnoses or inadequate treatment of NTM. Participants identified as top research priorities the prevention of NTM infection; approval of more effective treatments with fewer side effects and easier administration; understanding the best chest physiotherapy methods; validating and using tools to measure quality of life; and developing a disease-specific activity and severity assessment tool. Workshop participants agreed that two complementary objectives are critical to ensure the best achievable outcomes for patients: (1) additional clinician education to improve screening and diagnosis of NTM infections; and (2) development of a geographically distributed network of experts in NTM disease to offer consultation or direct therapy after a diagnosis is made.
Insights
Nontuberculous mycobacteria (NTM) lung disease requires better diagnosis and treatments. Patient input identified key research priorities, including prevention, effective therapies, and improved quality of life measures.
Area of Science:
- Pulmonology
- Infectious Diseases
- Patient-Centered Research
Background:
- Nontuberculous mycobacteria (NTM) cause chronic, debilitating lung disease, particularly in older adults.
- Diagnosis is frequently delayed, and current treatments involve prolonged, multi-antibiotic regimens with significant side effects and common relapses.
- The NTM Research Consortium (NTMRC) was formed to address the need for improved diagnostics and therapies.
Purpose of the Study:
- To define patient-centered research priorities for NTM lung infections.
- To incorporate patient and caregiver perspectives into research agenda setting.
- To identify critical areas for improving NTM disease management and outcomes.
Main Methods:
- A 1-day workshop convened patients, caregivers, advocates, clinicians, and researchers in Portland, Oregon.
- The meeting was funded by the Patient-Centered Outcomes Research Institute.
- Participants engaged in discussions to identify and prioritize research needs.
Main Results:
- Patients expressed frustration with delayed diagnoses and inadequate treatments for NTM lung disease.
- Top research priorities included NTM infection prevention, development of more effective and tolerable treatments, optimizing chest physiotherapy, validating quality of life tools, and creating a disease-specific assessment tool.
- Key objectives identified were enhancing clinician education for improved diagnosis and establishing a network of NTM experts for consultation and treatment.
Conclusions:
- Patient engagement is crucial for setting relevant research priorities in NTM lung disease.
- Addressing research gaps in prevention, treatment efficacy, quality of life, and diagnostic tools is essential.
- Improving clinician education and creating expert networks are vital for better patient outcomes in NTM infections.
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