Will vary dramatically according to the patient's age and clinical presentation. However, there are commonalities that can be highlighted.
Patients and their families should always be encouraged to take prescribed therapies, particularly in times of good health, because maintaining good health is crucial to long-term survival. Patients should be instructed on the proper administration of therapies, particularly supplemental pancreatic enzymes and chest physical therapy. Instruction should begin within the first two visits of diagnosis and should be reinforced as often as necessary.
Patients and their families should be instructed to maintain good communication with both a primary care provider and their CF care team.
Transition from pediatric to adult care
Medical advancements mean that individuals with CF are now living into adulthood. There is a need for a safe and planned transition to bridge from pediatric to adult care. The concept of transition should be introduced early so that the patient and the family can plan and prepare for this process. Transition should be individualized, gradually giving patients more responsibility from young adulthood (e.g., self-care, disease knowledge, and decision-making). A designated adult CF center should be identified before transfer to the adult health system.
Successful transition requires effective communication and partnership between pediatric and adult care teams. Establishing transition programs can facilitate this process.[188]García-Rodríguez F, Raygoza-Cortez K, Moreno-Hernandez L, et al. Outcomes of transitional care programs on adolescent chronic inflammatory systemic diseases: systematic review and meta-analyses. Pediatr Rheumatol Online J. 2022 Feb 17;20(1):15.
https://www.doi.org/10.1186/s12969-022-00670-1
http://www.ncbi.nlm.nih.gov/pubmed/35177101?tool=bestpractice.com
Exercise
Exercise improves aerobic capacity, lung function, and health‐related quality of life, while reducing disease severity and improving both prognosis and survival.[189]Nixon PA, Orenstein DM, Kelsey SF, et al. The prognostic value of exercise testing in patients with cystic fibrosis. N Engl J Med. 1992 Dec 17;327(25):1785-8.
https://www.nejm.org/doi/10.1056/NEJM199212173272504
http://www.ncbi.nlm.nih.gov/pubmed/1435933?tool=bestpractice.com
[190]Orenstein DM, Hovell MF, Mulvihill M, et al. Strength vs aerobic training in children with cystic fibrosis: a randomized controlled trial. Chest. 2004 Oct;126(4):1204-14.
http://www.ncbi.nlm.nih.gov/pubmed/15486384?tool=bestpractice.com
[191]Heinz KD, Walsh A, Southern KW, et al. Exercise versus airway clearance techniques for people with cystic fibrosis. Cochrane Database Syst Rev. 2022 Jun 22;6(6):CD013285.
https://www.doi.org/10.1002/14651858.CD013285.pub2
http://www.ncbi.nlm.nih.gov/pubmed/35731672?tool=bestpractice.com
[192]Radtke T, Smith S, Nevitt SJ, et al. Physical activity and exercise training in cystic fibrosis. Cochrane Database Syst Rev. 2022 Aug 9;8(8):CD002768.
https://www.doi.org/10.1002/14651858.CD002768.pub5
http://www.ncbi.nlm.nih.gov/pubmed/35943025?tool=bestpractice.com
An expert consensus statement concluded that physical activity and exercise present minimal risk if the patient receives appropriate guidance about hydration, nutrition, exercise intensity, and duration.[193]Williams CA, Barker AR, Denford S, et al. The Exeter Activity Unlimited statement on physical activity and exercise for cystic fibrosis: methodology and results of an international, multidisciplinary, evidence-driven expert consensus. Chron Respir Dis. 2022 Jan-Dec;19:14799731221121670.
https://www.doi.org/10.1177/14799731221121670
http://www.ncbi.nlm.nih.gov/pubmed/36068015?tool=bestpractice.com
Although exercise with huff or cough may improve mucus clearance, this should not replace other airway clearance techniques.[191]Heinz KD, Walsh A, Southern KW, et al. Exercise versus airway clearance techniques for people with cystic fibrosis. Cochrane Database Syst Rev. 2022 Jun 22;6(6):CD013285.
https://www.doi.org/10.1002/14651858.CD013285.pub2
http://www.ncbi.nlm.nih.gov/pubmed/35731672?tool=bestpractice.com
[193]Williams CA, Barker AR, Denford S, et al. The Exeter Activity Unlimited statement on physical activity and exercise for cystic fibrosis: methodology and results of an international, multidisciplinary, evidence-driven expert consensus. Chron Respir Dis. 2022 Jan-Dec;19:14799731221121670.
https://www.doi.org/10.1177/14799731221121670
http://www.ncbi.nlm.nih.gov/pubmed/36068015?tool=bestpractice.com