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Culturally Appropriate Outreach Specialist Respiratory Medical Care Improves the Lung Function of Children in Regional and Remote Queensland

  • PEDIATRIC PULMONARY DISEASE
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Abstract

Background and Objectives

Indigenous Respiratory Outreach Care (IROC) is a culturally appropriate specialist respiratory service established to deliver multidisciplinary respiratory care to regional and remote Queensland communities. Our objective was to evaluate the impact of an outreach specialist respiratory service on the spirometry of children attending IROC clinics, particularly Indigenous children with asthma and bronchiectasis.

Methods

Retrospective single-arm cohort study of 189 children who performed spirometry at twelve sites across regional and remote Queensland between October 2010 and December 2017. Each child’s baseline spirometry was compared to their best spirometry at follow-up visit occurring within (1) 12 months of their most recent visit with at least 12 months of specialist care and; (2) each year of their first 3 years of care.

Results

Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) z-scores improved significantly across the whole group from baseline to follow-up (change in z-scores (Δz) of FEV1 = 0.38, 95% CI 0.22, 0.53; ΔzFVC = 0.36, 95% CI 0.21, 0.51). In subgroup analyses, lung function significantly improved in Indigenous children (n = 141, ΔzFEV1 = 0.37, 95% CI 0.17, 0.57; ΔzFVC = 0.36, 95% CI 0.17, 0.55) including those with asthma (n = 117, ΔzFEV1 = 0.41, 95% CI 0.19, 0.64; ΔzFVC = 0.46, 95% CI 0.24, 0.68) and bronchiectasis (n = 38, ΔzFEV1 = 0.33, 95% CI 0.07, 0.59; ΔzFVC = 0.26, 95% CI − 0.03, 0.53). Significant improvements in FEV1 and FVC were observed within the first and second year of follow-up for Indigenous children, but not for non-Indigenous children.

Conclusion

The IROC model of care in regional and remote settings leads to significant lung function improvement in Indigenous children with asthma and bronchiectasis.

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Authors and Affiliations

  1. Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Level 5a, 501 Stanley St, Brisbane, QLD, 4101, Australia

    Andrew J. Collaro, Anne B. Chang, Julie M. Marchant, Ian B. Masters, Leanne T. Rodwell & Margaret S. McElrea

  2. Centre for Children’s Health Research, QLD, Queensland University of Technology, Brisbane, Australia

    Andrew J. Collaro, Anne B. Chang, Julie M. Marchant, Ian B. Masters, Allan J. Takken & Margaret S. McElrea

  3. Child Health Division, Menzies School of Health Research, Darwin, NT, Australia

    Anne B. Chang

  4. Indigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, QLD, Australia

    Anne B. Chang, Leanne T. Rodwell & Margaret S. McElrea

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  1. Andrew J. Collaro
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  2. Anne B. Chang
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Correspondence to Andrew J. Collaro.

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Collaro, A.J., Chang, A.B., Marchant, J.M. et al. Culturally Appropriate Outreach Specialist Respiratory Medical Care Improves the Lung Function of Children in Regional and Remote Queensland. Lung 198, 361–369 (2020). https://doi.org/10.1007/s00408-020-00332-7

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  • DOI: https://doi.org/10.1007/s00408-020-00332-7

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