Bringing Bronchiectasis Guidelines Into Everyday Practice

"Bringing Bronchiectasis Guidelines Into Everyday Practice" takes up the practical hurdles of translating new bronchiectasis guidelines into day-to-day patient care.

Dr. Basavaraj asks Dr. Khabbaza what challenges he anticipates in translating the new CHEST guidelines into everyday clinical practice. Dr. Khabbaza notes that a gap between guideline publication and routine bedside adoption is typical of any new guidance, and he expects the underlying knowledge gap to remain a central obstacle. He observes that even patients correctly labeled with bronchiectasis are sometimes still managed as though they have asthma or COPD, reflecting treatment inertia that persists even once terminology improves. He credits growing patient and provider awareness, including direct-to-consumer education, with moving the field in the right direction, but cautions that many clinicians lack hands-on experience with newer modalities such as inhaled antibiotics or tranexamic acid, which involve more operational complexity than writing a standard prescription. He recommends that community physicians partner with bronchiectasis care centers for initial guidance while directly managing components themselves to build practical experience over time.

Dr. Metersky adds that reducing the burden on physicians is equally important to successful implementation. He points to time-intensive tasks such as patient education for airway clearance and prior authorization paperwork, both of which can be delegated to a nurse practitioner or respiratory therapist and dedicated nursing staff, freeing physicians to focus where their expertise is most needed. Dr. Khabbaza adds that portal-delivered educational videos are a valuable adjunct, allowing patients and families to review material together outside the office visit.

Dr. Basavaraj notes that published guidelines are inherently limited to what available evidence supports, and highlights the Bronchiectasis and NTM Association's planned clinical consensus statements as a complementary resource. Dr. ElMaraachli frames these statements as practical, experience-based guidance from high-volume centers addressing questions where formal evidence remains too thin to support a guideline recommendation.

Up next, in the final episode, "The Future of Bronchiectasis Care: Precision Medicine Ahead," the panel shares its outlook on the future of bronchiectasis care.