NT Health is taking steps to improve treatment and outcomes for Aboriginal patients with lung disease.

The Department have completed a study focused on Aboriginal and Torres Strait Islander patients with bronchiectasis, a common respiratory condition.

Bronchiectasis is a type of chronic lung condition where patients can present with chronic cough, phlegm (lung mucus) and breathing difficulty or with frequent respiratory infections needing antibiotic treatment.

Dr Edwina Biancardi from the Royal Darwin Hospital Respiratory and Sleep Service said the study fills a gap in knowledge and raises awareness among adult Aboriginal people with bronchiectasis.

“Chronic respiratory disorders are highly prevalent among Aboriginal people living in the Top End, including bronchiectasis. There is little research in this space, so we can learn more about how to improve treatment and outcomes for patients through study outcomes,” Dr Biancardi said.

Past research shows bronchiectasis is common in Aboriginal children in the Northern Territory. However, until recently no studies had been conducted in adult Aboriginals in the Top End.

Dr Biancardi said in this study, demographics, clinical characteristics and relevant laboratory test results were compared among adult Aboriginal and non-Aboriginal patients at RDH diagnosed with bronchiectasis between 2012 and 2017.

“This study demonstrated the higher burden of bronchiectasis among adult Aboriginal people, compared to non-Aboriginal people, living in the Top End.

“It is the first of its kind in Australia that compares the clinical characteristics, demographic profile and outcomes among adult Aboriginal versus non-Aboriginal Australian patients with bronchiectasis within a defined single health service region,” Dr Biancardi said.                                     

The study found Aboriginal adults with bronchiectasis were much younger, had poorer lung function, more frequent exacerbations, and greater prevalence of respiratory and non-respiratory co-morbidities.

Dr Biancardi said the study will see the Royal Darwin Hospital Respiratory Service implementing improvements to service delivery to improve patient focused care, and ultimately increased health outcomes.     

“The service is looking at ways to provide a bronchiectasis self-management programme and an airway clearance programme to decrease recurrent chest infections, antibiotic usage and hospital admissions.

“The aim of these programmes is to help someone feel in control and independent with managing their respiratory illness.

“Our focus is ensuring a good understanding of devices for the management of bronchiectasis, provided through one-on-one face to face education sessions,  using airway clearance tools, that are demonstrated by the respiratory nurses and then replicated back by the patient to ensure their understanding and technique is correct and includes education on ‘better breathing techniques’,” Dr Biancardi said.

Study stats:

• Of the 388 patients with bronchiectasis during the study period, 258 (66.5%) were identified as Aboriginal
• Aboriginal patients with bronchiectasis were significantly younger (mean difference of 13 years) than non-Aboriginal
• Aboriginal patients had higher rates of co-occurrence of chronic obstructive pulmonary disease (65% v 38%) and other chronic co-morbidities compared to non-Aboriginal patients
• Aboriginal patients had poorer lung function compared to non-Aboriginal patients on lung function tests