Development of a core outcome set for trials of physiotherapy in bronchiectasis

Abstract

Physiotherapy is recommended for bronchiectasis management, but there is disparity in evidence supporting its use. This is partly because of inconsistency and poor reporting of outcomes in available trials. Core outcome set (COS) is defined as the minimum acceptable group of outcomes that should be used in all effectiveness trials evaluating physiotherapy in bronchiectasis. This thesis aimed to develop a COS for physiotherapy research in adults with bronchiectasis using a consensus process that involved three studies.
A systematic review of literature captured a total of 104 outcomes reported in physiotherapy for adult bronchiectasis trials. Then, a qualitative study involving interviews with patients with bronchiectasis and respiratory physiotherapists were conducted to discuss important outcomes from patients and clinicians’ point of view. Half of the outcomes identified were not previously reported in the literature. Outcomes elicited from the systematic review and interviews were combined forming a long-list of outcomes. The long-list informed an international Delphi study of two rounds to establish consensus on outcomes, involving researchers, patients, and clinicians. This was followed by consensus meeting to agree final COS based on the results of the Delphi study. Seven outcomes were agreed and recommended to be measured in all future trials: health-related quality of life, respiratory symptoms, physical functioning, emotional and psychological functioning, fatigue, adherence to treatment, and functional exercise capacity.
This thesis contributes to knowledge by providing a COS to be measured, as a minimum, in future physiotherapy trials in bronchiectasis. It is anticipated that the COS will then be adopted by trialists and used in future trials. This may decrease research waste by improving consistency in outcome measurement, studies can then be more easily synthesised in systematic reviews meta-analyses and inform guidelines that enhance physiotherapy evidence-based practice in bronchiectasis. This work also informs understanding of important and meaningful outcomes to both patients and physiotherapists.

Date of Award	20 Dec 2023
Original language	English
Awarding Institution	Edge Hill University
Supervisor	SALLY SPENCER (Director of Studies) & Carol Kelly (Supervisor)