Inside a Bronchiectasis Care Center: Building the Team

In "Inside a Bronchiectasis Care Center: Building the Team," the panel details the full range of specialists involved in comprehensive bronchiectasis care.

Dr. Basavaraj notes that the Bronchiectasis and NTM Association has established nearly 30 full care center network sites nationwide, alongside additional clinical associate centers, and asks Dr. ElMaraachli to describe the team makeup at a bronchiectasis center. Dr. ElMaraachli outlines a multidisciplinary model built around pulmonologists, infectious disease physicians, and advanced practice providers such as nurse practitioners and physician assistants. Respiratory therapists play an integral role, meeting with patients separately from the medical visit to review airway clearance equipment and technique, since there is rarely enough time to cover everything in one appointment.

A dedicated care coordinator tracks patients whose resource needs vary by severity, Dr. ElMaraachli explains, since more severe or drug-resistant patients require closer follow-up. A specialty pharmacist is equally essential, particularly for patients receiving intravenous antibiotics at home, where dosing must account for comorbid kidney impairment or low body mass index and where certain antibiotics require level monitoring. He describes the overall model as functioning like a mini inpatient service run through the outpatient clinic.

Beyond the core team, Dr. ElMaraachli lists cardiothoracic surgeons for patients with focal disease unresponsive to medical management, head and neck surgeons for chronic sinus disease, and nutrition and mental health specialists, acknowledging that consistent access to the latter two remains a personal challenge even within his own academic center.

Dr. Basavaraj adds that full care centers often provide access to clinical trials as patients meet enrollment criteria. Asked how smaller or community practices can build toward this model, Dr. ElMaraachli recommends standardizing care through an order panel covering etiology workup, airway clearance, and routine surveillance sputum cultures, which he says are frequently underused outside specialty settings. Empowering and educating patients, he adds, helps ensure care does not fall through the cracks when specialist access is limited.

In "Bronchiectasis Progression: Long-Term Consequences and Quality of Life," the panel will examine the long-term consequences of bronchiectasis and its impact on patients' quality of life.