Read by QxMD icon Read

clinical practice of copd

Michele Carron
Non-invasive ventilation (NIV) has assumed an important role in the management of acute respiratory failure (ARF). NIV, compared with standard medical therapy, improves survival and reduces complications in selected patients with ARF. NIV represents the first-line intervention for some forms of ARF, such as chronic obstructive pulmonary disease (COPD) exacerbations and acute cardiogenic pulmonary edema. The use of NIV is also well supported for immunocompromised patients who are at high risk for infectious complications from endotracheal intubation...
September 2016: Annals of Translational Medicine
Praful Schroff, Jason Hitchcock, Christopher Schumann, J Michael Wells, Mark T Dransfield, Surya P Bhatt
Rationale Current practice guidelines recommend pulmonary rehabilitation as an adjunct to standard pharmacologic therapy for individuals with moderate to severe chronic obstructive pulmonary disease (COPD). Whether pulmonary rehabilitation benefits all subjects with COPD independent of baseline disease burden is not known. Objective To test whether pulmonary rehabilitation benefits patients with COPD independent of baseline exercise capacity, dyspnea and lung function. Methods Data from a prospectively maintained database of participants with COPD enrolled in pulmonary rehabilitation at the University of Alabama at Birmingham from 1996 to 2013 was retrospectively analyzed...
October 14, 2016: Annals of the American Thoracic Society
Carlos A Camillo, Christian R Osadnik, Hans van Remoortel, Chris Burtin, Wim Janssens, Thierry Troosters
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Electronic databases were searched, identifying trials comparing exercise training with exercise training plus "add-on" therapy. Outcomes included peak oxygen uptake (V'O2peak), work rate and incremental/endurance cycle and field walking tests. Individual trial effects on exercise capacity were extracted and collated into eight subgroups and pooled for meta-analysis...
January 2016: ERJ Open Research
Esther I Metting, Johannes C C M In 't Veen, P N Richard Dekhuijzen, Ellen van Heijst, Janwillem W H Kocks, Jacqueline B Muilwijk-Kroes, Niels H Chavannes, Thys van der Molen
The aim of this study was to develop and explore the diagnostic accuracy of a decision tree derived from a large real-life primary care population. Data from 9297 primary care patients (45% male, mean age 53±17 years) with suspicion of an obstructive pulmonary disease was derived from an asthma/chronic obstructive pulmonary disease (COPD) service where patients were assessed using spirometry, the Asthma Control Questionnaire, the Clinical COPD Questionnaire, history data and medication use. All patients were diagnosed through the Internet by a pulmonologist...
January 2016: ERJ Open Research
Janine Margarita Dizon, Karen Grimmer, Shingai Machingaidze, Pam McLaren, Quinette Louw
BACKGROUND: Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant...
October 10, 2016: Health Research Policy and Systems
Gianna Camiciottoli, Francesca Bigazzi, Chiara Magni, Viola Bonti, Stefano Diciotti, Maurizio Bartolucci, Mario Mascalchi, Massimo Pistolesi
BACKGROUND: In addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD). Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH), ischemic heart disease, heart failure, peripheral vascular disease (PVD), diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema) and severity (mild and severe diseases) were determined by clinical and functional parameters...
2016: International Journal of Chronic Obstructive Pulmonary Disease
María José Bujalance-Zafra, Miguel Domínguez-Santaella, Antonio Baca-Osorio, Leovigildo Ginel-Mendoza, Francisco Jesús Fernández-Vargas, Rafael Poyato-Ramos
OBJECTIVE: To examine the impact of an intervention by Primary Care (PC) professionals of a Health District on the clinical outcomes for treating COPD exacerbations using a process and outcome indicators analysis (clinical audit). DESIGN: Observational, retrospective and prospective analysis cross-sectional audit of clinical practice SETTING: Malaga-Guadalhorce Sanitary District (DSMG). PARTICIPANTS: Patients with COPD exacerbations treated by the extra-hospital emergency services (n=523; 21% losses)...
September 27, 2016: Atencion Primaria
Dhamotharan Pattarayan, Rajesh K Thimmulappa, Vilwanathan Ravikumar, Subbiah Rajasekaran
Lack of markers of subclinical disease state and clinical phenotype other than pulmonary function test has made the diagnosis and interventions of environmental respiratory diseases a major challenge. MicroRNAs (miRNAs), small non-coding single stranded RNAs, have emerged as potential disease-modifier in various environmental respiratory diseases. They can also be found in various body fluids and are remarkably stable. Because of their high stability, disease-specific expression, and the ease to detect and quantify them have raised the potential of miRNAs in body fluids to be useful clinical diagnostic biomarkers for lung disease phenotyping...
September 27, 2016: Clinical Reviews in Allergy & Immunology
Ulrike Held, Alfons Kessels, Judith Garcia Aymerich, Xavier Basagaña, Gerben Ter Riet, Karel G M Moons, Milo A Puhan
Prediction models should be externally validated before being used in clinical practice. Many published prediction models have never been validated. Uncollected predictor variables in otherwise suitable validation cohorts are the main factor precluding external validation. We used individual patient data from 9 different cohort studies conducted in the United States, Europe, and Latin America that included 7,892 patients with chronic obstructive pulmonary disease who enrolled between 1981 and 2006. Data on 3-year mortality and the predictors of age, dyspnea, and airflow obstruction were available...
October 1, 2016: American Journal of Epidemiology
Nini H Jonkman, Heleen Westland, Jaap Ca Trappenburg, Rolf Hh Groenwold, Erik Wma Bischoff, Jean Bourbeau, Christine E Bucknall, David Coultas, Tanja W Effing, Michael J Epton, Frode Gallefoss, Judith Garcia-Aymerich, Suzanne M Lloyd, Evelyn M Monninkhof, Huong Q Nguyen, Job van der Palen, Kathryn L Rice, Maria Sedeno, Stephanie Jc Taylor, Thierry Troosters, Nicholas A Zwar, Arno W Hoes, Marieke J Schuurmans
BACKGROUND: Self-management interventions are considered effective in patients with COPD, but trials have shown inconsistent results and it is unknown which patients benefit most. This study aimed to summarize the evidence on effectiveness of self-management interventions and identify subgroups of COPD patients who benefit most. METHODS: Randomized trials of self-management interventions between 1985 and 2013 were identified through a systematic literature search...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Anne Marie Lyngsø, Nina Skavlan Godtfredsen, Anne Frølich
INTRODUCTION: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. METHODS: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark...
2016: International Journal of Integrated Care
Maria B Ospina, Kelly Mrklas, Lesly Deuchar, Brian H Rowe, Richard Leigh, Mohit Bhutani, Michael K Stickland
BACKGROUND: A COPD discharge bundle is a set of evidence-based practices aimed at improving patient outcomes after discharge from acute care settings following an exacerbation. We conducted a systematic review on the effectiveness of COPD discharge bundles and summarised their individual care elements. METHODS: Biomedical electronic databases and clinical trial registries were searched from database inception through April 2016 to identify experimental studies evaluating care bundles offered to patients with COPD at discharge...
September 9, 2016: Thorax
Jørgen Vestbo, David Leather, Nawar Diar Bakerly, John New, J Martin Gibson, Sheila McCorkindale, Susan Collier, Jodie Crawford, Lucy Frith, Catherine Harvey, Henrik Svedsater, Ashley Woodcock
Background Evidence for the management of chronic obstructive pulmonary disease (COPD) comes from closely monitored efficacy trials involving groups of patients who were selected on the basis of restricted entry criteria. There is a need for randomized trials to be conducted in conditions that are closer to usual clinical practice. Methods In a controlled effectiveness trial conducted in 75 general practices, we randomly assigned 2799 patients with COPD to a once-daily inhaled combination of fluticasone furoate at a dose of 100 μg and vilanterol at a dose of 25 μg (the fluticasone furoate-vilanterol group) or to usual care (the usual-care group)...
September 29, 2016: New England Journal of Medicine
Sara Roversi, Leonardo M Fabbri, Don D Sin, Nathaniel M Hawkins, Alvar Agusti
Chronic obstructive pulmonary disease (COPD) is a global health issue with high social and economic costs. Concomitant chronic cardiac disorders are frequent in patients with COPD, likely due to shared risk factors (e.g. ageing, cigarette smoke, inactivity, persistent low-grade pulmonary and systemic inflammation) and add to the overall morbidity and mortality of COPD patients. The prevalence and incidence of cardiac comorbidities are higher in COPD patients than in matched control subjects, although estimates of prevalence vary widely...
September 2, 2016: American Journal of Respiratory and Critical Care Medicine
Bernard Vrijens, Alexandra L Dima, Eric Van Ganse, Job F M van Boven, Michelle N Eakin, Juliet M Foster, Marijn de Bruin, Alison Chisholm, David Price
Adequate medication adherence is key for optimal benefit of pharmacological treatments. A wealth of research has been conducted to understand and identify opportunities to intervene to improve medication adherence, but variations in adherence definitions within prior research have led to ambiguity in study findings. The lack of a standard taxonomy hinders the development of cumulative science in adherence research. This article reviews the newly established Ascertaining Barriers to Compliance (ABC) taxonomy for medication adherence with a particular focus on its relevance and applicability within the context of asthma and chronic obstructive pulmonary disease management...
September 2016: Journal of Allergy and Clinical Immunology in Practice
Lutz Beckert, Rachel Wiseman, Suzanne Pitama, Amanda Landers
OBJECTIVES: Non-invasive ventilation (NIV) is widely used as a lifesaving treatment in acute exacerbations of chronic obstructive pulmonary disease; however, little is known about the patients' experience of this treatment. This study was designed to investigate the experiences and perceptions of participants using NIV. The study interprets the participants' views and explores implications for clinical practice. METHODS: Participants with respiratory failure requiring NIV were interviewed 2 weeks after discharge...
August 31, 2016: BMJ Supportive & Palliative Care
Katrine Rutkær Molin, Ingrid Egerod, Laura Staun Valentiner, Peter Lange, Henning Langberg
BACKGROUND: In Denmark, the treatment of COPD is mainly managed by general practitioners (GPs). Pulmonary rehabilitation (PR) is available to patients with COPD in the local community by GP referral, but in practice, many patients do not participate in rehabilitation. The aim of our study was to explore 1) GPs' perceptions of their role and responsibility in the rehabilitation of patients with COPD, and 2) GPs' perceptions of how patients manage their COPD. METHODS: The study was based on a qualitative design with semi-structured key-informant interviews with GPs...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Hege Mari Johnsen, Mariann Fossum, Pirashanthie Vivekananda-Schmidt, Ann Fruhling, Åshild Slettebø
BACKGROUND: Serious games (SGs) are a type of simulation technology that may provide nursing students with the opportunity to practice their clinical reasoning and decision-making skills in a safe and authentic environment. Despite the growing number of SGs developed for healthcare professionals, few SGs are video based or address the domain of home health care. AIMS: This paper aims to describe the design, development, and usability evaluation of a video based SG for teaching clinical reasoning and decision-making skills to nursing students who care for patients with chronic obstructive pulmonary disease (COPD) in home healthcare settings...
October 2016: International Journal of Medical Informatics
Daniel G Fein, Ali N Zaidi, Roxana Sulica
Pulmonary hypertension (PH) due to chronic respiratory disease and/or hypoxia is classified as World Health Organization (WHO) Group III pulmonary hypertension. The patients most commonly encountered in clinical practice with group III PH include those with chronic obstructive lung disease (COPD), diffuse parenchymal lung disease, and sleep-disordered breathing. The purpose of this review is to outline the variable clinical significance of pulmonary hypertension in the most common pulmonary disease states and how a clinician may approach the management of these patients...
August 26, 2016: Journal of Clinical Medicine
James Davis, Elizabeth Tam, Deborah Taira
The objectives of the study were to compare ethnic differences in the rates of emergency department (ED) visits and hospitalizations, and to examine ethnic differences in how quickly patients with either chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) developed both diseases. A large health plan in Hawai.i provided administrative data (2007 to 2010) on patients of Native Hawaiian, Japanese, Chinese, Filipino, and White race/ethnicity. The study found distinct patterns of health risks among the multi-ethnic population of patients with COPD, CHF, or both conditions...
August 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"