For bronchiectasis preventing disease progression means to facilitate airway clearance, suppress bacterial infection and prevent exacerbations.5 Management of these patients requires a comprehensive multimodal therapeutic approach including airway clearance, reducing chronic infection and inflammation, and treatment of exacerbations.5 Antibiotics, especially in the inhalational form, reduce exacerbations and inflammation by decreasing bacterial density. Together, these various treatments work in concert to improve the overall status of the patient with bronchiectasis.5
Patients should be made aware of the range of available airway clearance techniques including HFCWO vest therapy, like the AffloVest®, huff coughing, bronchodilators, hypertonic saline, positive expiratory pressure and exercise. Patient preference and adherence to treatment should be considered when recommending and discussing airway clearance techniques. The frequency and duration of the airway clearance technique should be tailored to the individual and may alter during periods of exacerbation.5
When choosing an airway clearance therapy, it is important to take into consideration both the patient’s and the physician’s suggestions and preferences. An airway clearance regimen should be effective, efficient, easy to use, able to be undertaken independently or with minimal assistance, and should improve lung function. It should also be flexible, comfortable and adaptable to meet the changing needs of the individual patient.