Indicators of pulmonary exacerbation in cystic fibrosis: A Delphi survey of patients and health professionals

- Two Delphi studies to identify indicators of an exacerbation in Cystic Fibrosis (CF).
- Delphi 1: (31 adults with CF) ranked subjective indicators highly.
- Delphi 2: (38 CF health professionals) ranked objective indicators highly.
- Patient reported signs/symptoms could be a precursor to an exacerbation.
- Health professionals should take more cognisance of patient reported signs/symptoms.

BackgroundThere is uncertainty about the most important indicators of pulmonary exacerbations in CF.MethodsTwo parallel Delphi surveys in 13 CF centres (UK and Ireland). Delphi 1: 31 adults with CF, ≥ one exacerbation over 12 months. Delphi 2: 38 CF health professionals. Rounds 1 and 2 participants rated their level of agreement with statements relating to indicators of exacerbation; Round 3 participants rated the importance of statements which were subsequently placed in rank order.ResultsObjective measurements were of higher importance to health professionals. Feelings of increased debility were rated most important by adults with CF.ConclusionsThere were clear differences in perspectives between the two groups as to the most important indicators of an exacerbation. This highlights that CF health professionals should take more cognisance of specific signs and symptoms reported by adults with CF, especially since these may be a precursor to an exacerbation.