Respiratory Physiotherapist – Clinical Researcher, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp
Dr Jason Suggett
Group Director, Science and Technology, Trudell Medical International
Quality of life is hugely important to any COPD patient. Research into Airway Clearance Therapy suggests that mucus clearance is just the tip of the iceberg in terms of its benefits to patients.
Some 1.2 million people in the UK live with chronic pulmonary obstruction disease (COPD).
The disease can have a drastic effect on a patient’s quality of life and worsens over time, with the patients slowly losing lung functionality.
Symptoms like chronic shortness of breath (dyspnoea), constant coughing and producing excessive quantities of mucus, each provide challenges for patients.
A new, ground-breaking study, into what effect clearing mucus can have when combined with effective inhaled drugs on the patient’s airways and medication delivery in the lung, has positive future implications for clinical outcomes.
Loosening mucus by pulsing pressure through the airways
The study saw 10 patients treated with a hand-held oscillating positive expiratory pressure device (OPEP), which is designed to aid mucus clearance in the lungs by generating pressure pulses in the airways. The mucus became less sticky and easier to shift, while opening smaller airways in the lungs for longer during exhalation.
Glenn Leemans is a respiratory physiotherapist and clinical researcher at the University of Antwerp. He is also the first author of this study.
Leemans believes, focussing on mucus clearance in patients with moderate to extremely severe COPD can benefit them in terms of their overall quality of life, while also helping to prevent ‘exacerbations’ – instances where symptoms flare up and require medical attention.
Excess mucus can seriously impact physical and emotional quality of life
“Living with this excess mucus has a tremendous effect on a patient’s quality of life. Coughing it up can be terrible.
“Mucus is also harmful to the patient medically, given it is a breeding ground for infections and a catalyst for the type of exacerbations that require hospital treatment.”
“There’s also the stigma and the mental effect of that. If you’re coughing up a lot, with friends or with other people, it draws attention to you.
“There’s a psychological effect, which is hard to bury for a lot of patients.”
Improved lung ventilation also improves inhalation of medicines
Leemans’ study found that patients who used the OPEP device expanded their airway volume, meaning there is more place for air to pass easily during exhalation.
Leemans also saw lung ventilation improve, resulting in a better deposition of the patient’s inhaled medicines – an observation that may spark further research into the positive effect of OPEP devices on the efficacy of inhaled drug therapies.
“The evidence base we have already is more than enough to suggest that those who work in this field should be prescribing use of OPEP devices more often than they are currently. We don’t, as a community, need to wait for the guidelines to change.”
That OPEP devices should increasingly form part of COPD patient’s treatment plans is a notion shared by Dr Jason Suggett, Group Director, Science and Technology at Trudell Medical International.
Many patients are now using this mucus-clearing device
“The device is already being used by a lot of patients,” says Dr Jason Suggett, Group Medical Director at Trudell. “We’re getting to a tipping point in terms of how big the body of evidence is now. With more, high quality, evidence being produced, then hopefully use of the devices will become part of COPD guidelines.”
Dr Suggett continues: “We have already seen that combining this non-drug therapy with their existing drug therapy is likely to help the patient have a better quality of life.”
With exacerbation triggered hospitilisations often lasting several days, the cost to the NHS of one hospital visit could be in the thousands.
Reducing the likelihood of patients having
those exacerbations and requiring hospital treatment – whilst also doing much
to improve their experience of the disease – is a win/win for both.
 British Lung Foundation, 2019
About Aerobika® OPEP device
 Wolkove N, et al. Use of a Mucus Clearance Device Enhances the Bronchodilator Response in Patients With Stable COPD. CHEST 2002;121(3):702-707. |  Leemans G, et al. A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease. International Journal of COPD 2020;15 1261-1268. |  Mussche C, et al. Poster presented at: American Thoracic Society Annual Conference. May 18-23, 2018. San Diego, United States. |  Burudpakdee C, et al. A Real-World Study of 30-Day Exacerbation Outcomes in Chronic Obstructive Pulmonary Disease (COPD) Patients Managed with Aerobika* OPEP Pulm Ther 2017;3(1):163-171.
UK AB 078 0620 | Date of preparation June 2020