Nurse led oscillating positive expiratory pressure (OPEP) and the impact on quality of life using the St George's Respiratory Questionnaire (SGRQ)

<bold>Introduction:</bold> The Knowsley Community Respiratory Team is a multidisciplinary team that diversifies traditional roles within health care to enhance and compliment patient care. Nurse led OPEP was proposed to enable holistic treatment for patients as an adjunct to traditionally initiated pharmacological interventions. The nursing staff were trained by the physiotherapy team, which allowed patients to be treated promptly within one consultation. <bold>Methods:</bold> A total of 40 patients with COPD (27) and bronchiectasis (13) were included. Male: 31; Female: 9. Ex-smoker: 30; Current smokers: 7; Never smokers: 3. Patients were reviewed in the community setting. Following clinical assessment and established mucopurulent or purulent sputum, which was difficult to expectorate, OPEP was initiated. A SGRQ at baseline and again at week two was completed on all 40 patients. The Active Cycle of Breathing Technique (fig1) was advised pre and post OPEP 2 – 3 times daily (or as tolerated). Settings were adjusted according to patient preference/tolerance. <bold>Results:</bold> Clinically meaningful improvements in SGRQ total score between baseline and week 2 favoured the initiation of OPEP, (total score, symptoms score, activity score and impact score) (p<0.005). Patient feedback was also positive in all 40 patients: ‘Changed my life’ ‘Feel I can breathe so much better’ ‘My chest feels relieved and clear’. <bold>Conclusion:</bold> This study demonstrates that in patients with COPD and bronchiectasis, Nurse led OPEP in conjunction with the Active Cycle of Breathing Technique, improves quality of life and symptom burden.