Table 2.
Access to clinic, surveillance and screening tests, and guideline-recommended treatments by travel time.
| One-way travel time by automobile to SPH, min | p value | ||||
|---|---|---|---|---|---|
| <45 (n = 85) | 45–150 (n = 28) | 150–360 (n = 42) | >360 (n = 13) | ||
| Routine clinic visits | |||||
| Routine clinic visits, mean (SD) | 3.8 (2.1) | 3.6 (1.9) | 2.2 (1.5)∗ | 2 (1.5)∗ | <0.001 |
| ≥4 routine clinic visits, n (%) | 45 (53%) | 15 (54%) | 10 (24%)∗ | 2 (15%)∗ | 0.002 |
| Routine surveillance and screening tests | |||||
| Routine sputum cultures, mean (SD) | 3.6 (1.9) | 3.4 (1.7) | 2.4 (1.8)∗ | 2.5 (1.9) | 0.004 |
| ≥4 routine sputum cultures, n (%) | 47 (55%) | 14 (50%) | 12 (29%)∗ | 4 (31%) | 0.023 |
| Bone density measurement, n (%) | 19 (22%) | 11 (39%) | 7 (17%) | 2 (15%) | 0.2 |
| Annual CF bloodwork, n (%) | 49 (58%) | 17 (61%) | 25 (60%) | 7 (54%) | 1.0 |
| ≥1 NTM culture, n (%) | 71 (84%) | 24 (86%) | 29 (69%) | 10 (77%) | 0.2 |
| Access to guideline-recommended pulmonary therapies | |||||
| Grade A: inhaled antibioticsa, PsA+ and severeb or moderatec lung disease, n (%) | 17 (89%) | 11 (92%) | 8 (80%) | 2 (100%) | 0.8 |
| Grade A: dornase alfa, severe or moderate lung disease, n (%) | 19 (59%) | 12 (80%) | 15 (88%) | 3 (60%) | 0.1 |
| Grade B: inhaled antibiotics, PsA+ and mildd lung disease, n (%) | 5 (42%) | 1 (50%) | 3 (50%) | 1 (100%) | 0.9 |
| Grade B: dornase alfa, mild lung disease or normal lung function, n (%) | 18 (38%) | 2 (18%) | 6 (32%) | 2 (67%) | 0.7 |
| Grade B: azithromycin, PsA+ and negative NTM culture, n (%) | 22 (73%) | 11 (85%) | 13 (81%) | 2 (100%) | 0.5 |
| Grade B: hypertonic saline, any disease, n (%) | 35 (41%) | 8 (29%) | 11 (26%) | 3 (23%) | 0.3 |
Mean (standard deviation), or n (%).
NTM: nontuberculous mycobacteria; PsA+: P. aeruginosa isolates in ≥ 50% of annual sputum cultures.
aInhaled antibiotics included tobramycin (powdered or nebulized) and aztreonam.
bSevere lung disease: FEV1% predicted < 40%.
cModerate lung disease: FEV1% predicted 40–69%.
dMild lung disease: FEV1% predicted 70–90%.
∗ = Statistically significant difference compared to reference group (one-way driving travel time < 45 minutes).