{
  "abstract": "Introduction Asthma is a chronic respiratory condition affecting over 300 million people globally, with difficult asthma comprising 5–10% of cases. People with difficult asthma often experience persistent symptoms that are resistant to standard high-dose treatments, contributing to a significant public health and economic burden. Multidisciplinary assessments, including input from speech and language therapy (SALT) and physiotherapy, have been proposed to complement traditional pharmacological interventions by targeting symptom control and reducing exacerbations, particularly in individuals with low inflammatory biomarkers (Type 2-low). This study evaluates the clinical impact of these therapies on outcomes in people with difficult asthma.Methods A retrospective study was conducted at the Leeds Difficult Asthma Clinic. Data from 50 patients treated with SALT or physiotherapy between January 2020 and December 2021 were collected. Outcomes included Asthma Control Questionnaire (ACQ) scores, spirometry parameters, exacerbation frequencies, and treatment discharge rates. Statistical analyses assessed the effectiveness of these interventions, with comparisons made pre- and post-treatment at 12 months.Results The cohort included 41 females and 9 males, with a median (range) age of 47 (17–82) years. At baseline, the median (range) BMI and FEV 1 were 30.7 (16.5–56.0) and 2.27 (0.64–4.25) L, respectively. Median (range) eosinophil counts were low; 0.18 (0.01–23.1) × 109 cells/L, consistent with a Type 2-low asthma phenotype. A significant overall reduction in exacerbations was observed (32.7%, p=0.03), with females experiencing a greater decrease (38.6%, p<0.05). BMI, FEV1, and ACQ scores did not show significant changes (p>0.05), Notably, 42% of patients were discharged from therapy, suggesting improved symptom control and meaningful clinical improvement.Conclusion This study highlights the potential of SALT and physiotherapy as effective adjunctive therapies for difficult asthma. Given the substantial reduction in exacerbation rates and the significant proportion of patients achieving successful discharge, these non-pharmacological approaches represent a valuable addition to difficult asthma assessment and management. They may also offer a cost-effective alternative to biological therapies, particularly for people with Type 2-low asthma, who often respond poorly to conventional pharmacological interventions. Future research should further explore the long-term impact and broader applicability of these therapies across diverse populations.",
  "authors": [
    {
      "affiliations": [
        "University of Leeds, Leeds, UK"
      ],
      "name": "Y Durmus"
    },
    {
      "affiliations": [
        "University of Leeds, Leeds, UK"
      ],
      "name": "N Kennedy"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust, Leeds, UK"
      ],
      "name": "F Cicognini"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust, Leeds, UK"
      ],
      "name": "N Nixon"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust, Leeds, UK"
      ],
      "name": "R Salman"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust, Leeds, UK"
      ],
      "name": "I Clifton"
    }
  ],
  "title": "P74 Improving outcomes in difficult asthma: clinical impact of physiotherapy and speech and language therapy in multidisciplinary care",
  "uid": "0b22cfba-8047-5616-8d44-3d15e21e3374"
}