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NPJ Primary Care Respiratory Medicine

Josefin Sundh, Scott Montgomery, Mikael Hasselgren, Mary Kämpe, Christer Janson, Björn Ställberg, Karin Lisspers
Health status is a prognostic factor included in the assessment of chronic obstructive pulmonary disease (COPD). The aim of our study was to examine the associations of clinical factors with change in health status over a 7-year follow-up period. In 2005, 970 randomly selected primary and secondary care patients with a COPD diagnosis completed questionnaires including the Clinical COPD Questionnaire (CCQ); and in 2012, 413 completed the CCQ questionnaire again. Linear regression used difference in mean total CCQ score between 2005 and 2012 as the dependent variable...
October 20, 2016: NPJ Primary Care Respiratory Medicine
Christian Bime, Joe K Gerald, Christine Y Wei, Janet T Holbrook, William G Teague, Robert A Wise, Lynn B Gerald
The childhood Asthma-Control Test (C-ACT) is validated for assessing asthma control in paediatric asthma. Among children aged 4-11 years, the C-ACT requires the simultaneous presence of both parent and child. There is an unmet need for a tool that can be used to assess asthma control in children when parents or caregivers are not present such as in the school setting. We assessed the psychometric properties and estimated the minimally important difference (MID) of the C-ACT and a modified version, comprising only the child responses (C-ACTc)...
October 20, 2016: NPJ Primary Care Respiratory Medicine
Luis Ig Ribeiro, Philip W Ind
As cannabis use increases, physicians need to be familiar with the effects of both cannabis and tobacco on the lungs. However, there have been very few long-term studies of cannabis smoking, mostly due to legality issues and the confounding effects of tobacco. It was previously thought that cannabis and tobacco had similar long-term effects as both cause chronic bronchitis. However, recent large studies have shown that, instead of reducing forced expiratory volume in 1 s and forced vital capacity (FVC), marijuana smoking is associated with increased FVC...
October 20, 2016: NPJ Primary Care Respiratory Medicine
Job Fm van Boven, Alan G Kaplan
No abstract text is available yet for this article.
October 20, 2016: NPJ Primary Care Respiratory Medicine
César Alameda, Ángel Carlos Matía, Verónica Casado
No abstract text is available yet for this article.
October 20, 2016: NPJ Primary Care Respiratory Medicine
Manon Belhassen, Anjan Nibber, Eric Van Ganse, Dermot Ryan, Carole Langlois, Francis Appiagyei, Derek Skinner, Laurent Laforest, Joan B Soriano, David Price
Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases...
October 13, 2016: NPJ Primary Care Respiratory Medicine
Patrick T White, Timothy H Harries
No abstract text is available yet for this article.
October 13, 2016: NPJ Primary Care Respiratory Medicine
Hanneke Ac van Helvoort, Laura M Willems, Pn Richard Dekhuijzen, Hieronymus Wh van Hees, Yvonne F Heijdra
In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV1 88±s...
October 13, 2016: NPJ Primary Care Respiratory Medicine
Barbara P Yawn, Samy Suissa, Andrea Rossi
International guidance on chronic obstructive pulmonary disease (COPD) management recommends the use of inhaled corticosteroids (ICS) in those patients at increased likelihood of exacerbation. In spite of this guidance, ICS are prescribed in a large number of patients who are unlikely to benefit. Given the evidence of the risks associated with ICS and the limited indications for their use, there is interest in understanding the effects of withdrawing ICS when prescribed inappropriately. In this review, we discuss the findings of large ICS withdrawal trials, with primary focus on the more recent trials using active comparators...
September 29, 2016: NPJ Primary Care Respiratory Medicine
Tjard R Schermer, Bas Robberts, Alan J Crockett, Bart P Thoonen, Annelies Lucas, Joke Grootens, Ivo J Smeele, Cindy Thamrin, Helen K Reddel
Clinical guidelines indicate that a chronic obstructive pulmonary disease (COPD) diagnosis is made from a single spirometry test. However, long-term stability of diagnosis based on forced expiratory volume in 1 s over forced vital capacity (FEV1/FVC) ratio has not been reported. In primary care subjects at risk for COPD, we investigated shifts in diagnostic category (obstructed/non-obstructed). The data were from symptomatic 40+ years (ex-)smokers referred for diagnostic spirometry, with three spirometry tests, each 12±2 months apart...
September 29, 2016: NPJ Primary Care Respiratory Medicine
Deborah Morrison, Karolina Agur, Stewart Mercer, Andreia Eiras, Juan I González-Montalvo, Kevin Gruffydd-Jones
The term multimorbidity is usually defined as the coexistence of two or more chronic conditions within an individual, whereas the term comorbidity traditionally describes patients with an index condition and one or more additional conditions. Multimorbidity of chronic conditions markedly worsens outcomes in patients, increases treatment burden and increases health service costs. Although patients with chronic respiratory disease often have physical comorbidities, they also commonly experience psychological problems such as depression and anxiety...
September 15, 2016: NPJ Primary Care Respiratory Medicine
Liza Cragg, Siân Williams, Thys van der Molen, Mike Thomas, Jaime Correia de Sousa, Niels H Chavannes
No abstract text is available yet for this article.
2016: NPJ Primary Care Respiratory Medicine
Sarah B Brien, George T Lewith, Mike Thomas
Quality of life (QoL) has a weak relationship with lung function (LF) impairment in COPD; some cope well despite poor LF, whereas others suffer disproportionate QoL impairment despite well-preserved LF. Adjuvant non-pharmacological interventions such as rehabilitation and psychological/behavioural support may help if acceptable and targeted appropriately, but they are under-used and sometimes declined by patients. This study aimed to explore and understand variations in experiences and coping strategies in patients with different severities of disease and disease-specific QoL...
2016: NPJ Primary Care Respiratory Medicine
Miguel Santibañez Margüello, Roberto Garrastazu, Mario Ruiz-Nuñez, Jose Manuel Helguera, Sandra Arenal, Cristina Bonnardeux, Carlos León, Marc Miravitlles, Juan Luis García-Rivero
Few studies have researched the independent effect of COPD severity on the risk of future exacerbations adjusted by previous exacerbation frequency. We aimed to analyse the independent effect of COPD severity on the risk of exacerbations in the following year, and whether this effect was stronger or not than the effect of a previous history of exacerbations. We conducted a retrospective population-based cohort study including 900 patients with confirmed COPD. Exacerbation frequency was observed for the previous year and for the following year...
2016: NPJ Primary Care Respiratory Medicine
Frederik van Gemert, Niels Chavannes, Bruce Kirenga, Rupert Jones, Sian Williams, Ioanna Tsiligianni, Judith Vonk, Janwillem Kocks, Corina de Jong, Thys van der Molen
In Uganda, biomass smoke seems to be the largest risk factor for the development of COPD, but socio-economic factors and gender may have a role. Therefore, more in-depth research is needed to understand the risk factors. The aim of this study was to investigate the impact of socio-economic factors and gender differences on the COPD prevalence in Uganda. The population comprised 588 randomly selected participants (>30 years) who previously completed the FRESH AIR Uganda study. In this post hoc analysis, the impact of several socio-economic characteristics, gender and smoking on the prevalence of COPD was assessed using a logistic regression model...
2016: NPJ Primary Care Respiratory Medicine
Harma Alma, Corina de Jong, Danijel Jelusic, Michael Wittmann, Michael Schuler, Bertine Flokstra-de Blok, Janwillem Kocks, Konrad Schultz, Thys van der Molen
The minimal clinically important difference (MCID) defines to what extent change on a health status instrument is clinically relevant, which aids scientists and physicians in measuring therapy effects. This is the first study that aimed to establish the MCID of the Clinical chronic obstructive pulmonary disease (COPD) Questionnaire (CCQ), the COPD Assessment Test (CAT) and the St George's Respiratory Questionnaire (SGRQ) in the same pulmonary rehabilitation population using multiple approaches. In total, 451 COPD patients participated in a 3-week Pulmonary Rehabilitation (PR) programme (58 years, 65% male, 43 pack-years, GOLD stage II/III/IV 50/39/11%)...
2016: NPJ Primary Care Respiratory Medicine
Sally A Hull, Shauna McKibben, Kate Homer, Stephanie Jc Taylor, Katy Pike, Chris Griffiths
Inappropriate prescribing in primary care was implicated in nearly half of asthma deaths reviewed in the UK's recent National Review of Asthma Deaths. Using anonymised EMIS-Web data for 139 ethnically diverse general practices (total population 942,511) extracted from the North and East London Commissioning Support Unit, which holds hospital Secondary Uses Services (SUS)-linked data, we examined the prevalence of over-prescribing of short-acting β2-agonist inhalers (SABA), under-prescribing of inhaled corticosteroid (ICS) inhalers and solo prescribing of long-acting β2-agonists (LABA) to assess the risk of hospitalisation for people with asthma for 1 year ending August 2015...
2016: NPJ Primary Care Respiratory Medicine
Sonia Maria Martins, William Salibe-Filho, Luís Paulo Tonioli, Luís Eduardo Pfingesten, Patrícia Dias Braz, Juliet McDonnell, Siân Williams, Débora do Carmo, Jaime Correia de Sousa, Hilary Pinnock, Rafael Stelmach
Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented 'matrix support': a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals...
2016: NPJ Primary Care Respiratory Medicine
Adrian Loerbroks, Aziz Sheikh, Verena Leucht, Christian J Apfelbacher, Andrea Icks, Peter Angerer
Patients' needs in asthma remain insufficiently understood and met. We therefore aimed to investigate the potential determinants of patients' needs in asthma treatment. Our study was based on survey data on 189 adults with asthma. Needs were measured using the 13-item Needs in Asthma Treatment questionnaire, which yields a total score and subscale-specific scores ('exacerbations', 'patient expertise', 'handling drugs' and 'drug effects'). We considered age, sex, education, years since diagnosis and anxiety/depression (measured by the Patient Health Questionnaire-4) as potential determinants...
2016: NPJ Primary Care Respiratory Medicine
Ioanna Tsiligianni, Esther Metting, Thys van der Molen, Niels Chavannes, Janwillem Kocks
COPD symptoms show a diurnal variability. However, morning and night variability has generally not been taken into consideration in disease management plans. The aims of this study were to cross-sectionally assess morning and night symptom prevalence and correlation with health status and disease severity in COPD, and to determine to what extent they could predict longitudinal outcomes, exacerbations and health status. A further aim is to explore whether the CCQ is able to depict this morning/night symptomatology...
2016: NPJ Primary Care Respiratory Medicine
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