Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

Hall, Kathleen; Maxwell, Lyndal; Cobb, Robyn; Steele, Michael; Chambers, Rebecca; Roll, Mark; Bell, S. C.; Kuys, Suzanne

doi:10.1177/14799731211017895

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Professionals whose roles and responsibilities are to deliver exercise testing and training, 27 32 alongside physiotherapy assistants within CF MDTs, can prove useful 33 by relieving physiotherapy pressures while adding exercise expertise to the wider service. 34 The importance of experienced and qualified staff is recognised in recent clinical exercise testing guidelines, 11 and supported by a nationwide effort in the UK to establish clinical exercise physiologists within the healthcare workforce. 35 Considering this increased value of exercise professionals is alongside increasing recognition for the health benefits associated with exercise by society in general, perceived benefit of CFTR modulator treatments on perspectives on quality of life and health status 36 and the recognised benefit of exercise professionals by pwCF themselves; 37 CF MDTs should consider the incorporation of exercise specialists 27 or clinical exercise physiologists 35 into their teams.…”

Section: Discussionmentioning

confidence: 99%

Survey of exercise testing and training in cystic fibrosis clinics in the UK: a decade of progress

et al. 2023

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ObjectivesRegular exercise testing is recommended for people with cystic fibrosis (pwCF), as is the provision and regular review of exercise training programmes. A previous survey on exercise testing and training for pwCF in the UK was conducted over a decade ago. With the landscape of CF changing considerably during this time, this survey aimed to evaluate UK-based exercise testing and training practices for pwCF a decade on.DesignCross-sectional, online survey.ParticipantsA survey was distributed electronically to UK CF clinics and completed by the individual primarily responsible for exercise services. Descriptive statistics and qualitative analyses were undertaken.ResultsIn total, 31 CF centres participated, representing ~50% of UK specialist clinics. Of these, 94% reported using exercise testing, 48% of which primarily use cardiopulmonary exercise testing. Exercise testing mostly occurs at annual review (93%) and is most often conducted by physiotherapists (62%). A wide variation in protocols, exercise modalities, normative reference values and cut-offs for exercise-induced desaturation are currently used. All centres reportedly discuss exercise training with pwCF; 94% at every clinic appointment. However, only 52% of centres reportedly use exercise testing to inform individualised exercise training. Physiotherapists typically lead discussions around exercise training (74%).ConclusionsThese data demonstrate that the majority of respondent centres in the UK now offer some exercise testing and training advice for pwCF, representing a marked improvement over the past decade. However, continued efforts are now needed to standardise exercise practices, particularly regarding field testing practices and the translation of test results into personalised training programmes for pwCF.

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Section: Discussionmentioning

confidence: 99%

Survey of exercise testing and training in cystic fibrosis clinics in the UK: a decade of progress

et al. 2023

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“…patient's home) may require greater investment in training and upskilling of AHAs and the development of competencies specific to these areas of practice. [34,35].…”

Section: Discussionmentioning

confidence: 99%

Delegation of patient related tasks to allied health assistants: a time motion study

Snowdon

King

Dennett

et al. 2022

BMC Health Serv Res

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Background Allied health assistants (AHAs) are support staff who complete patient and non-patient related tasks under the delegation of an allied health professional. Delegating patient related tasks to AHAs can benefit patients and allied health professionals. However, it is unclear whether the AHA workforce is utilised optimally in the provision of patient care. The purpose of this study was to determine the proportion of time AHAs spend on patient related tasks during their working day and any differences across level of AHA experience, clinical setting, and profession delegating the task. Methods A time motion study was conducted using a self-report, task predominance work sampling method. AHAs were recruited from four publicly-funded health organisations in Victoria, Australia. AHAs worked with dietitians, occupational therapists, physiotherapists, podiatrists, social workers, speech pathologists, psychologists, and exercise physiologists. The primary outcome was quantity of time spent by AHAs on individual task-categories. Tasks were grouped into two main categories: patient or non-patient related activities. Data were collected from July 2020 to May 2021 using an activity capture proforma specifically designed for this study. Logistic mixed-models were used to investigate the extent to which level of experience, setting, and delegating profession were associated with time spent on patient related tasks. Results Data from 51 AHAs showed that AHAs spent more time on patient related tasks (293 min/day, 64%) than non-patient related tasks (167 min/day, 36%). Time spent in community settings had lower odds of being delegated to patient related tasks than time in the acute hospital setting (OR 0.44, 95%CI 0.28 to 0.69, P < 0.001). Time delegated by exercise physiologists and dietitians was more likely to involve patient related tasks than time delegated by physiotherapists (exercise physiology: OR 3.77, 95% 1.90 to 7.70, P < 0.001; dietetics: OR 2.60, 95%CI 1.40 to 1.90, P = 0.003). Time delegated by other professions (e.g. podiatry, psychology) had lower odds of involving patient related tasks than physiotherapy (OR 0.37, 95%CI 0.16 to 0.85, P = 0.02). Conclusion AHAs may be underutilised in community settings, and by podiatrists and psychologists. These areas may be targeted to understand appropriateness of task delegation to optimise AHAs’ role in providing patient care.

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“…The use of patient narratives in the form of "talking heads" videos and the positive deviance approach showed promise in inspiring confidence, promoting behavior change, and providing valuable insights into overcoming barriers to treatment adherence for individuals with CF [ 75 ]. Successful integration of an Advanced Healthcare Assistant (AHA) within an adult CF center, resulting in changes to physiotherapy service provision, increased complexity of clinical care, expanded physiotherapist roles, improved patient communication, and no reported safety issues, emphasizing the potential of AHAs to enhance service delivery in other acute respiratory physiotherapy settings [ 76 ].…”

Section: Reviewmentioning

confidence: 99%

Hope in Every Breath: Navigating the Therapeutic Landscape of Cystic Fibrosis

Sreenivasulu,

Muppalla,

Vuppalapati

et al. 2023

Cureus

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Cystic fibrosis (CF) has long posed a complex challenge to medical science. Still, the tides are turning with remarkable progress in prognosis and demographics, thanks to cutting-edge medical management and treatment breakthroughs. It affects multiple systems, necessitating a comprehensive approach to its management. This article thoroughly reviews the latest advancements in CF treatment across three key areas: respiratory care, infection prevention, and pharmacological management. In respiratory care, emphasis is placed on airway clearance therapies and nebulized saline, while infection prevention strategies encompass hand hygiene, respiratory etiquette, and environmental cleaning and disinfection. Pharmacological management explores pancreatic enzyme replacement therapy (PERT), antimicrobial treatments, cystic fibrosis transmembrane regulator (CFTR) modulators, and promising gene therapies. Patient education and support are highlighted as crucial components of effective CF management, while mental health assessments are emphasized due to CF patients' susceptibility to anxiety and depression. This review highlights the tremendous progress made in the management of CF. Integrating early detection, infection prevention, pharmacological interventions, gene therapy, and patient support is revolutionizing the care and quality of life for individuals with CF.

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Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

Cited by 7 publications

References 29 publications

Survey of exercise testing and training in cystic fibrosis clinics in the UK: a decade of progress

Survey of exercise testing and training in cystic fibrosis clinics in the UK: a decade of progress

Delegation of patient related tasks to allied health assistants: a time motion study

Hope in Every Breath: Navigating the Therapeutic Landscape of Cystic Fibrosis

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