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Utility of a personalised Bronchiectasis Action Management Plan (BAMP) for children with bronchiectasis: protocol for
Julie M Marchant1,2, Anne B Chang3,2,4,5, Kobi L Schutz4,6
1Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia jm.marchant@qut.edu.au.
Insights
This study investigates if individualized bronchiectasis action management plans (BAMPs) reduce doctor visits for children with bronchiectasis. Results aim to improve care for this under-researched respiratory condition.
Area of Science:
- Pediatric Respiratory Medicine
- Clinical Trial Research
- Chronic Lung Disease Management
Background:
- Bronchiectasis in children is under-researched despite causing significant morbidity.
- Individualized action plans improve outcomes in other chronic respiratory diseases.
- Bronchiectasis action management plans (BAMPs) are rarely used in pediatric bronchiectasis.
Purpose of the Study:
- To determine if individualized bronchiectasis action management plans (BAMPs) reduce non-scheduled doctor consultations in children with bronchiectasis.
- To evaluate the impact of BAMPs on quality of life and exacerbation rates.
- To provide evidence for the utility of BAMPs in pediatric respiratory care.
Main Methods:
- A multicentre, parallel, double-blind, randomised trial involving 198 children (aged <19 years) with bronchiectasis.
- Participants randomized to receive an individualized BAMP or standard care.
- Primary outcome: rate of acute non-scheduled doctor visits over 12 months; secondary outcomes include quality of life and exacerbation rates.
Main Results:
- Data collection ongoing; results pending.
- Primary outcome measure is the rate of acute non-scheduled doctor visits for respiratory exacerbations.
- Secondary outcomes include cough-specific quality of life scores and overall exacerbation rates.
Conclusions:
- The study hypothesizes that BAMPs will reduce healthcare utilization for pediatric bronchiectasis.
- Findings will inform clinical practice and patient management strategies.
- The BAMP will be made freely available online upon study completion.
Introduction:
Bronchiectasis is no longer considered rare or irreversible in children, yet it remains relatively under-researched and neglected in respiratory health globally. Bronchiectasis (including chronic suppurative lung disease) causes substantial morbidity for patients and significant impact on caregivers, especially during acute respiratory exacerbations. In other chronic respiratory diseases (eg, asthma), empowering consumers with an individualised plan for management of acute exacerbations improves clinical outcomes. However, in the absence of any such data specific to bronchiectasis, action management plans are rarely currently used in children or adults with bronchiectasis. We hypothesise that providing an individualised bronchiectasis action management plan (BAMP) to children with bronchiectasis reduces non-scheduled doctor consultations, compared with not having a BAMP.
Methods And Analysis:
This multicentre, parallel, double-blind, randomised trial involving three urban Australian hospitals commenced in June 2018 and will include 198 children, aged <19 years with bronchiectasis who had 2 or more exacerbations in the previous 18 months. Children will be randomised to having an individualised BAMP or standard care (a decoy clinic letter). Primary caregivers will then be followed up monthly for 12 months. The primary outcome is the rate of acute non-scheduled doctor visits for respiratory exacerbations by 12 months. The main secondary outcomes are cough-specific quality of life scores at 6 and 12 months, overall exacerbation rate over 12 months, and proportion of children who received timely influenza vaccination by 30 May annually.
Ethics And Dissemination:
The Human Research Ethics Committees of the Northern Territory Department of Health and Menzies School of Heath Research and Queensland Children's Hospital approved the study. The results of the trial will be submitted for publication and the BAMP made available free online.
Trial Registration Number:
Australia and New Zealand Clinical Trials Register ACTRN12618000604202.
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