{
  "abstract": "Background Bronchiectasis is chronic lung condition. Symptoms include productive cough and mucus hypersecretion. Airway clearance techniques (ACTs) are non-pharmacological interventions that support removal of mucus from the lungs. Consensus guidelines recommend ACTs are taught by specialist respiratory physiotherapists. Regional services providing specialist physiotherapy for people with bronchiectasis can be difficult to access. This can result in suboptimal management within primary care networks (PCNs), exacerbating existing health inequalities.Aims To explore a local PCN’s:Management of bronchiectasis patients with mucus hypersecretionBarriers to referring bronchiectasis patients to specialist respiratory physiotherapyMethods A multiple choice online survey was completed by staff from GP practices within a North East and North Cumbria (NENC) primary care network (PCN). All participants treated bronchiectasis patients in their role. Snowballing recruitment was used. The survey was designed by two respiratory physiotherapists in the region. Results were collated manually using Microsoft excel.Results Twenty-six health-care professionals across 14 GP practices in the NENC PCN. Results are shown in table 1. Management of patients with bronchiectasis with hypersecretion included oral cysteine 22/26 (85%), education (e.g., written instructions on ACTs) 15/26 (58%), referral to specialist bronchiectasis clinic 9/26 (35%), referral to respiratory physiotherapist 7/26 (27%) and prescription of an airway clearance oscillating positive pressure (OPEP) device 2/26 (8%). Barriers for referral to respiratory physiotherapy included lack of referral pathway 12/26 (46%), lack of knowledge on role of respiratory physiotherapy 9/26 (35%), long waiting times 1/26 (4%) and other 4/26 (15%).Discussion Management of bronchiectasis patients with mucus hypersecretion in primary care is heterogenous. Oral cysteines are the most common treatment for hypersecretion in this PCN. Written information on ACTs, and prescription of ACT adjuncts (OPEP) are provided in primary care by non-specialist health professionals. Lack of pathway is the most common perceived barrier to refer patients to respiratory physiotherapy.Abstract P39 Table 1Conclusion Developing established pathways for from primary care to respiratory physiotherapy may improve access for patients. Additionally, educating primary care staff on the role of respiratory physiotherapy and how to appropriately prescribe ACTs (e.g., OPEP devices) in primary care, may support more equitable access to this essential treatment for bronchiectasis patients.",
  "authors": [
    {
      "affiliations": [
        "Newcastle University, Newcastle Upon Tyne, UK"
      ],
      "name": "P McCallion"
    },
    {
      "affiliations": [
        "Copeland Haven, Cumbria, UK"
      ],
      "name": "A Burgess"
    }
  ],
  "title": "P39 Survey of North Cumbria GP practices management of bronchiectasis patients with hypersecretion and perceived barriers to referral for respiratory physiotherapy",
  "uid": "919b6dab-6971-5a82-9006-e56a5f738c8c"
}