Improving outcomes in bronchiectasis through a treatable traits approach- an implementation study

<bold>Background:</bold> Treatable traits are identifiable, measurable, clinically relevant features of disease that if targeted for treatment, have the potential to improve health outcomes. <bold>Aim:</bold> To determine if the implementation of a treatable traits approach to clinical care in adults with bronchiectasis in a clinic led by allied health professionals and nurses would improve health outcomes. <bold>Methods:</bold> A pilot implementation study. New outpatients with confirmed bronchiectasis who attended a clinic in Rockhampton, Australia between 2020-2023 were invited to participate. Clinical care was implemented by allied health professionals and nurses according to traits identified and prioritised with the patient. Quality of life (QoL-Bronchiectasis respiratory symptom (QoL-B rs), Leicester Cough Questionnaire (LCQ) total score), and annual exacerbation frequency (self-reported diary record) were evaluated at baseline, three and 12 months from first attendance. <bold>Results:</bold> 50 participants were recruited [mean (SD) age 71 (12) years; Bronchiectasis Severity Index (%) mild (22), moderate (44), severe (34)]. To date, there is data available for 45 participants at 12 months. There was a clinically significant improvement in QoL at three and 12 months from baseline [3 months: QoL-B rs mean difference (95% CI) 10.1 (3.9-16.3), LCQ 1.8 (0.8-2.8); 12 months: QoL-B rs 9.2 (3.2-15.2), LCQ 1.7 (0.6-2.8)]. Exacerbation frequency decreased compared with baseline [median (IQR) from 1.0 (3.0) to 0.0 (1.0), p<0.05). <bold>Conclusion:</bold> A treatable traits approach to clinical care implemented by allied health professionals and nurses improved quality of life, and reduced exacerbation frequency in adults with bronchiectasis.