Framework proposed for bronchiectasis and NTM care in safety-net systems

This article describes a practical framework, developed by centers within the Bronchiectasis and NTM Care Center Network, for adapting guideline-concordant care to under-resourced health systems. The authors note that existing clinical practice guidelines assume reliable access to subspecialty evaluation, advanced diagnostics, and costly therapies, which is often not available in safety-net settings, and propose four domains: earlier-recognition diagnostic pathways, co-management models prioritizing high-risk patients, pragmatic resource-aligned approaches to evidence-based therapies, and linguistically and culturally responsive patient education. The authors state that aligning recommendations with structural realities is necessary to improve care delivery and reduce inequality in this population.

Most relevant for: Clinicians managing bronchiectasis and nontuberculous mycobacterial pulmonary disease in community and safety-net health systems with limited access to subspecialty and diagnostic resources.

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