P6 What guidelines say and what actually happens: a survey of UK physiotherapy practice in the management of Non-Tuberculous Mycobacterial Pulmonary Disease

<h3>Introduction and Objectives</h3> Physiotherapy review including advice on sputum clearance and lifestyle management are guideline-recommended approaches to managing Non-Tuberculous Mycobacterial pulmonary disease (NMT-PD). Despite this, a recent national survey found less than half of clinicians treating NTM-PD had access to physiotherapy input for their patients. There are currently no UK data on clinical physiotherapy practices for patients with NTM-PD; we investigated this using an online survey. <h3>Methods</h3> A physiotherapy specific national survey was developed and distributed electronically by NTM Network UK, Physiotherapy Interest Group via the professional physiotherapy societies ACPRC and ACPCF to respiratory physiotherapists with potential involvement in the management of paediatric and/or adults with NTM-PD. It asked about NTM-PD services provided, sputum microbiology surveillance, delivery of airway clearance provision/advice and current physiotherapy patient-management. <h3>Results</h3> Of 53 responses, 80% were from university hospitals or CF units and 20% District General hospitals. Two-thirds treated adults, and almost half had a speciality interest in bronchiectasis or CF. 60% were referred NTM-PD patients, with the commonest indications being sputum clearance (90–98% inpatients and outpatients respectively), nebuliser trials (62–76%), sputum induction (55–58%) and advice on mobility &amp; exercise (54–68%). Physiotherapy outpatient review was scheduled every 1–3 months for around 40% of new NTM-PD patients; whilst 60% of stable NTM-PD patients were reviewed every 1–12 months. One third of new patients and 40% of established NTM-PD diagnoses had no routine physiotherapy review. The selection of airway clearance techniques or device provision frequently depended on funding and experience of the physiotherapist. Sputum surveillance was performed routinely by 75% of respondents, which included 2–3 mycobacterial cultures plus bacteriology. Where standards of care or guidelines (including Infection Prevention &amp; Control) were reported as available, these were predominantly extrapolated from CF management. <h3>Conclusions</h3> Service provision for people with NTM-PD is variable across the UK. Many of our survey respondents had considerable experience managing NTM-PD due to their engagement in CF centre care, possibly generating better than average results. Through the NTM Network we are developing national quality standards for physiotherapy which are intended to enable patients with NTM-PD to access high-quality services wherever they are managed.