News in brief: Budget funds for lung cancer nurses; Dysphagia tested in COPD; Adults with CF reliable at home spirometry

13 May 2021

Funding boost for lung cancer nurses

The 2021-22 Federal Budget includes funding for five additional lung cancer nurses.

The relatively modest investment  has been welcomed by Lung Foundation Australia (LFA), which has been advocating for more lung cancer clinical nurse specialists and care coordinators to support patients through their cancer journey.

In 2020 the LFA said Australia was lagging behind many other nations, with as few as 12 full-time equivalent specialist nurses for 12,700 people with lung cancer.

“We remain committed to growing the specialised lung cancer workforce so it reaches parity with more than 520 specialised prostate and breast cancer nurses,” said CEO Mark Brooke.


Home spirometry acceptable for CF patients 

Unsupervised home spirometry using a portable spirometer during the first year of the COVID-19 pandemic was generally of an acceptable quality and provided repeatable results.

A study from the Royal Prince Alfred Hospital adult CF clinic compared unsupervised spirometry results with those taken again, within 24 hours, during a remote consultation supervised by a respiratory scientist using video conferencing.

Most remote spirometry was conducted at home (84.5%) and occasionally at work (2.8%) or at a GP clinic (1.4%).

The study found the majority of the 74 patients achieved ATS/ERS grade A (excellent) or B (very good) spirometry quality with (95%) and without supervision (91%) independent of lung function severity or age.

Participants with poorer grades (C‐F) either experienced technical difficulties with their devices or failed to perform a sufficient number of manoeuvres.

The results were presented at the TSANZSRS 2021 ASM.


Breathing-swallowing coordination out in COPD

Swallowing efficiency is reduced in patients with COPD however it is not related to anterior tongue strength, according to a small Australian study.

The study found COPD patients took longer to swallow both solids and liquids compared to healthy controls. As well, swallow times were longer in patients with more severe COPD.

The investigators, from Neuroscience Research Australia, said disruption to breathing-swallowing coordination is the most common cause of dysphagia in COPD and aggravated by a higher respiratory rate.

“Therefore, to address these complex swallowing dynamics in stable COPD, improving respiratory-swallowing coordination (e.g. using biofeedback, as piloted in a head and neck cancer cohort) rather than tongue strengthening exercises may be more beneficial,” they said.

“Training methods to improve swallowing-breathing coordination, and the impaired occlusion reflex could be implemented to reduce exacerbations, hospitalization costs, and improve the quality of life for people with COPD.”

ERJ Open Research


 

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