Enhancing procedural quality and efficiency of methacholine bronchial challenge tests in patients with suspected cough-variant asthma: a quasi-experimental study utilizing nurse–patient communication and respiratory training - Report - MDSpire
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Enhancing procedural quality and efficiency of methacholine bronchial challenge tests in patients with suspected cough-variant asthma: a quasi-experimental study utilizing nurse–patient communication and respiratory training
Clinical Report: Improving the Quality and Efficiency of Methacholine Tests
Overview
This study evaluates the impact of COMFORT-based nurse-patient communication and respiratory training on the quality of methacholine bronchial challenge tests (MBCT) in patients with suspected cough-variant asthma. Results indicate significant improvements in first-attempt success rates, testing duration, and maneuver quality.
Background
Methacholine bronchial challenge testing is crucial for assessing airway hyperresponsiveness in patients with suspected cough-variant asthma, a condition often characterized by chronic cough without wheezing. The execution of MBCT can be technically challenging, and patient anxiety may hinder performance, leading to suboptimal results. Improving procedural quality is essential for accurate diagnosis and management of asthma.
Data Highlights
Outcome
Intervention Group
Control Group
P-value
First-attempt success rate
75.6%
24.4%
< 0.001
In-chamber testing duration (min)
11.85 ± 3.12
16.90 ± 3.85
< 0.001
Optimal FVC (L)
2.95 ± 0.32
2.58 ± 0.35
< 0.001
Optimal FEV1 (L)
2.05 ± 0.25
1.70 ± 0.28
< 0.001
SAS score
35.10 ± 7.85
39.50 ± 8.12
0.015
SDS score
30.05 ± 5.90
35.80 ± 6.25
< 0.001
Adverse events
7.3%
24.4%
0.032
MBCT positivity rate
29.3%
17.1%
0.190
Key Findings
The intervention group had a significantly higher first-attempt success rate (75.6%) compared to the control group (24.4%).
In-chamber testing duration was shorter in the intervention group (11.85 min) versus the control group (16.90 min).
Optimal FVC and FEV1 values were significantly higher in the intervention group.
Post-procedure anxiety scores (SAS and SDS) were lower in the intervention group.
Mild procedure-related adverse events were less frequent in the intervention group (7.3% vs. 24.4%).
The MBCT positivity rate was numerically higher in the intervention group but not statistically significant.
Clinical Implications
The integration of COMFORT-based communication and respiratory training may enhance the quality of MBCTs.
Conclusion
The study demonstrates that combining empathetic communication with respiratory training can significantly enhance the quality of MBCTs.
