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Key messages from the allied respiratory professionals at the ERS Congress 2020

Last Update 06/04/2021

Every year the European Respiratory Society (ERS) organises a Congress for health professionals and scientists from all over the world. At the Congress, scientists and health professionals present new scientific and clinical findings. One of the groups of people who present at the Congress is called the allied respiratory professionals. These people are healthcare workers who work together with medical doctors. The goal is to provide the best care for patients with lung diseases. The following specialties are represented within the allied respiratory professionals’ group:

  • Lung function scientists – experts in measuring lung function
  • Physiotherapists – experts in physical treatment and rehabilitation
  • Nurses – experts in providing daily care to patients

Below you can find a summary of the most important findings that the allied respiratory professionals’ group presented at the ERS International Congress 2020.

Lung function scientists

The lung function scientists focused on how digital technology is changing their job and how to use quality control processes in breathing tests to ensure that they collect the best quality data.

A patient talked about her experience managing her asthma during lockdown and explained how to perform a video consultation. This was followed by a talk from a respiratory doctor involved in treating and managing asthma remotely (from a distance). They explained the importance of using technology to adjust patient care during a remote consultation, including using inhalers equipped with smart meters (electronic devices that record information and provide feedback to the user).

There were also several examples of how technology can help healthcare professionals to diagnose disease and identify high-risk patients. One speaker addressed a common concern about artificial intelligence; stating “a computer is not better than a human brain, but a computer supporting the human brain is better than the human brain alone.”

As the world becomes more connected by technology, it has become easier for laboratories to share what ‘normal’ breathing tests look like to people all over the world. The definition of what is ‘normal’ is important as it impacts on how we classify disease. Other sessions reviewed how to best perform the exercise test and the benefits of using a simulator, which mimics a patient exercising, to check if the exercise testing equipment is accurate. Finally, there was a presentation about an excellent example of how to simplify the operation of a sleep clinic and an update on improvements in how to automate quality control checks, which may save time and reduce human error. 

This year, the ERS Congress provided an excellent overview of advances in the field for Lung Function Scientists. There were messages of hope mixed with guidance to avoid potential pitfalls. As long as we focus on the patient, these technologies will help us to raise the quality of care in a digital world.

Physiotherapists

Physiotherapists highlighted the need to investigate the long-term impact of airway clearance techniques, which aim to help you cough up sputum so that it can be removed from the lungs. Factors like preference, ability, needs, age and treatment adherence (patients performing the airway clearance techniques as instructed) need to be considered when selecting the optimal airway clearance technique for a specific patient.

Physiotherapists also discussed the role of physical activity for people with obstructive sleep apnoea to reduce cardiovascular risk. They advised that being physically active according to the circadian rhythm, also called the “body clock” or “internal clock”, can be better for these patients. The circadian rhythm is a natural process which regulates many body functions including eating, sleeping, body temperature and hormone production.  

Physiotherapists emphasised the increasing demand for rehabilitation programmes for post-COVID patients and the opportunities for pulmonary rehabilitation services to speed up recovery.

Finally, physiotherapists presented about tests that assess frailty. Someone with frailty is more likely to experience certain health problems and recover more slowly from illness. Frailty is common in people with chronic obstructive pulmonary disease (COPD) and is seen in up to 1 in 10 patients. Frailty is the strongest indicator of survival in people with COPD. This means that people with lower levels of frailty are more likely to live longer. Frailty may occur during illness and hospitalisation. Physiotherapists showed that rehabilitation can prevent and even reverse frailty. They explained that exercise is an important tool for people with respiratory disease and frailty.

Nurses

Nurses presented two sessions during the ERS Congress. The first session offered information about new aspects of nursing care for people with lung diseases:

  • Healthcare professionals should monitor treatment adherence (patients taking medications as instructed) and explore reasons for not adhering. For example, involving patients in their inhaler management (shared decision) may improve how acceptable the inhaler is to the patient.
  • Patients recognised the importance of involving specialised healthcare professionals to enable them to self-manage their condition. This means taking part in activities to protect or improve their own care.
  • Online training is an opportunity to keep nurses up to date with the latest evidence.
  • Scientists showed that patients value the specialised training and experience that healthcare professionals have. Also, patients were more confident when their general practitioner followed up with them and they were given treatment during an emergency episode at home.
  • As part of routine care, health professionals should consider measuring the physical and emotional aspects of patients living with lung conditions.

The second session explored psychological symptoms in people living with lung disease. Nurses talked about creating a confidential environment to discuss patients and carers’ concerns. They showed how patients’ fears can impact on their own care. For example, it was shown that patients with higher “fear of getting short of breath” performed less physical activity and had a worse quality of life. This session also discussed strategies that can be used to promote self-management:

  • Using empathy (understanding how another person feels) can be helpful to improve patients’ experiences and to increase the number of patients taking their medications as prescribed.
  • The use of cognitive behavioural therapy, which is an intervention aimed to change people’s way of thinking or behaviour, decreases anxiety levels.
  • Early palliative care (specialised care for people living with incurable diseases) is useful for patients dealing with poor quality of life and difficult symptoms.

Finally, one patient presented his experience of living with idiopathic pulmonary fibrosis (IPF). He highlighted the importance of the patient-nurse relationship, saying that “sometimes it is the simplest gestures that can help to unlock suppressed emotions”. 

 

Interested in a more detailed summary? Please click on the link below: https://openres.ersjournals.com/content/early/2020/11/12/23120541.00808-2020

This summary was co-authored by lung function scientists and technologists, physiotherapists, physiologists and nurses working in the respiratory field, in the clinical and academic contexts.

Elizabeth Smith, Max Thomas, Ebru Calik-Kutukcu, Irene Torres-Sánchez, Maria Granados-Santiago, Juan Carlos Quijano-Campos, Karl Sylvester, Chris Burtin, Andreja Sajnic, Jana De Brandt, Joana Cruz

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