S56 A feasibility randomised control trial (RCT) of OPEP verses active cycle of breathing technique (ACBT) in people with chronic obstructive pulmonary disease (COPD)

<h3></h3> NICE guideline NG115 for COPD recommend Airways Clearance Techniques (ACTs) for people with excessive sputum but there have been no studies comparing different ACTs. <h3>Aim</h3> To compare Oscillatory Positive Expiratory Pressure (OPEP, Aerobika^TM ) vs Active Cycle of Breathing Technique (ACBT) following exacerbations of COPD. <h3>Method</h3> A pilot, feasibility randomised controlled trial (ClinicalTrials.gov Identifier: NCT05548036 <h3>Patient</h3> With confirmed COPD (GOLD 2023) and chronic bronchitis symptoms, who had not received ACTs previously. They were recruited in hospital or through community COPD nurses during (or within 4 days) of starting a moderate-severe exacerbation. Randomisation via sealed envelope determined whether they received 30–60 minutes of training on OPEP or ACBT by respiratory physiotherapists, face-to-face. All participants received antibiotics, steroids, nebulisers and oxygen in the acute phase according to clinical discretion. All were already prescribed optimal inhaled treatments. Participants were advised to continue twice daily OPEP or ACBT at home for at least 6 months. Groups were similar at baseline (all p=N.S). See table 1. <h3>Primary Outcome</h3> Leicester Cough Questionnaire (LCQ) at 3 months post-intervention (via intention to treat analysis). <h3>Results</h3> Mean (SD) Total LCQ at 3 months in the OPEP group was 87.3 (27.3) vs 91.9 (29.2) in the ACBT group, p=0.73, 95% CI -33 to +23.8. <h3>Conclusion</h3> Both groups showed statistically significant and clinically important improvement in LCQ, post-exacerbation (MDCID 1.5–2 LCQ) but there is no significant difference in LCQ scores between OPEP (Aerobika^TM ) vs ACBT groups at 3 months.