Which Assessments and Interventions do Physiotherapists Value in the Management of Adults with Cystic Fibrosis in Australia?

Abstract

Purpose: Evidence based practice involves the integration of three main components: best available research evidence, practitioner’s clinical expertise, and patient’s preferences. While the effectiveness of physiotherapy interventions for patients with cystic fibrosis (CF) has been extensively studied, no studies have explored physiotherapists’ perceptions and values concerning their management of patients with CF. The aim of this study was to document the opinions and values that CF physiotherapists in Australia have regarding their management of patients with CF. Method: A purpose-designed questionnaire addressing these issues was mailed to all 38 physiotherapists working with adults with CF on a regular/frequent basis in major Australian healthcare units. Results: Thirty-three questionnaires were returned completed (87%). Subjective history was considered by respondents as the most valuable component of assessment, with personal experience being the primary factor influencing this response. Coughing/huffing was deemed one of the most valuable airway clearance techniques across five different clinical scenarios; non-invasive ventilation, postural drainage, percussion and vibrations were perceived as valuable techniques for unwell, hospitalised patients; and exercise, positive expiratory pressure and flutter therapy/Acapella were considered valuable for out-patients. Personal experience was the factor most often influencing respondents’ opinions about treatment techniques. Conclusions: CF physiotherapists in Australia appear to mainly base their opinions about the value/usefulness of physiotherapy management of adults with CF on their past clinical experience. These data provide an initial insight into CF physiotherapists’ clinical expertise and will give CF clinicians around the world the opportunity to compare their own clinical practice with that of their Australian peers.