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https://www.readbyqxmd.com/read/28328942/the-value-of-theory-in-programmes-to-implement-clinical-guidelines-insights-from-a-retrospective-mixed-methods-evaluation-of-a-programme-to-increase-adherence-to-national-guidelines-for-chronic-disease-in-primary-care
#1
Jessica Sheringham, Francesca Solmi, Cono Ariti, Abigail Baim-Lance, Steve Morris, Naomi J Fulop
BACKGROUND: Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in 'real-world' rather than research settings. MATERIALS AND METHODS: This mixed-methods study tested a retrospective theory-based approach to evaluate a 'real-world' programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care...
2017: PloS One
https://www.readbyqxmd.com/read/28324969/a-clinical-study-of-short-term-sternal-photoplethysmography-recordings-from-patients-with-obstructive-airways-diseases
#2
Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen
Traditionally, measurements of the oxygen saturation (SpO2) has been confound to the extremities. In this study, we therefore investigated the possibility for reliable estimation of clinically relevant SpO2 levels from photoplethysmography (PPG) obtained on the sternum of patients with obstructive airway diseases. We initiated the study with a calibration of a prototype sternal PPG sensor. In accordance with the ISO 80601-2-61:2011 guidelines, the calibration was conducted as a controlled desaturation study...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321336/guideline-based-early-detection-of-chronic-obstructive-pulmonary-disease-in-eight-danish-municipalities-the-top-kom-study
#3
Ulla Borup Hemmingsen, Margit Stycke, Jens Dollerup, Peter Bo Poulsen
Background. Early detection of chronic obstructive pulmonary disease (COPD) and prevention of disease progression are important. Only 40% of COPD cases are diagnosed in Denmark. Recommendations for early case finding have been established. This study investigates early detection of pulmonary obstruction in a Danish municipality setting. Methods. Eight municipalities participated. Citizens fulfilling national case finding recommendations, age ≥35 years, smokers/ex-smokers/relevant occupational exposure, and at least one respiratory symptom, were invited to spirometry...
2017: Pulmonary Medicine
https://www.readbyqxmd.com/read/28306326/classification-of-airflow-limitation-based-on-z-score-underestimates-mortality-in-patients-with-chronic-obstructive-pulmonary-disease
#4
Elena Tejero, Eva Prats, Raquel Casitas, Raúl Galera, Paloma Pardo, Adelaida Gavilán, Elisabet Martínez-Cerón, Carolina Cubillos-Zapata, Luis Del Peso, Francisco García-Río
RATIONALE: Global Lung Function Initiative recommends reporting lung function measures as z-score, and a classification of airflow limitation (AL) based on this parameter has recently been proposed. OBJECTIVE: To evaluate the prognostic capacity of the AL classifications based on z-score or percentage predicted in patients with chronic obstructive pulmonary disease (COPD). METHODS: A cohort of 2614 COPD patients recruited outside the hospital setting was examined after 57±13 months of follow-up, totalling 10,322 person-years...
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#5
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28294320/nursing-clinical-practice-changes-to-improve-self-management-in-chronic-obstructive-pulmonary-disease
#6
J M Padilha, P A F Sousa, F M S Pereira
AIM: To propose nursing clinical practice changes to improve the development of patient self-management. BACKGROUND: Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. INTRODUCTION: Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living...
March 13, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28292581/-chronic-obstructive-pulmonary-disease-in-real-life-leonpoc-study
#7
Silvia García García, Luis Carazo Fernández, Javier Juan García, José Cesáreo Rilo Naveiro
OBJECTIVE: The purpose of this study was to evaluate different characteristics of COPD patients according to phenotypes and GOLD guidelines.according to GesEPOC phenotypes and GOLD 2011 ABCD guidelines and pharmacological treatment agreement. DESIGN: Cross-sectional survey. LOCATION: COPD patients aged 40-85 from León were randomly selected from Primary Care database, MEDORA. PARTICIPANTS: 5222 eligible COPD patients were collected from MEDORA database...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28291535/the-health-burden-and-economic-costs-averted-by-ambient-pm2-5-pollution-reductions-in-nagpur-india
#8
Tunde O Etchie, Saravanadevi Sivanesan, Gregory O Adewuyi, Kannan Krishnamurthi, Padma S Rao, Ayotunde T Etchie, Ajay Pillarisetti, Narendra K Arora, Kirk R Smith
National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM2.5) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM2.5 concentrations - including interim target 2 (IT-2), interim target 3 (IT-3), and the WHO air quality guideline (AQG) - in Nagpur district to inform policy decision making for mitigation...
March 10, 2017: Environment International
https://www.readbyqxmd.com/read/28284323/optimizing-drug-delivery-in-copd-the-role-of-inhaler-devices
#9
REVIEW
Paola Rogliani, Luigino Calzetta, Angelo Coppola, Francesco Cavalli, Josuel Ora, Ermanno Puxeddu, Maria Gabriella Matera, Mario Cazzola
Inhaled medication is the cornerstone of the pharmacological treatment for patients with asthma and chronic obstructive pulmonary disease (COPD). Several inhaler devices exist, and each device has specific characteristics to achieve the optimal inhalation of drugs. The correct use of inhaler devices is not granted and patients may incur in mistakes when using pressurized metered-dose inhalers (pMDIs) or dry-powder inhaler (DPIs). The incorrect use of inhaler devices can lead to a poorly controlled disease status...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28283854/management-of-the-asthma-copd-overlap-syndrome-acos-a-review-of-the-evidence
#10
REVIEW
Kristin L Hines, R Stokes Peebles
PURPOSE OF REVIEW: Examine the definition of the asthma-COPD overlap syndrome (ACOS) and current treatment strategies. RECENT FINDINGS: Patients with the ACOS have a lower quality of life and suffer from more complications than those affected by either disease alone. Diagnosis of ACOS is difficult because of the clinical similarities between the two diseases and the various phenotypes that comprise the syndrome. Defining treatment strategies for ACOS has been challenging because many clinical trials for asthma therapy have purposefully excluded patients with features of COPD, and COPD clinical trials have not included patients who might have an asthmatic component to their disease...
March 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28282500/morning-symptoms-in-copd-a-treatable-yet-often-overlooked-factor
#11
Amanda R van Buul, Marise J Kasteleyn, Niels H Chavannes, Christian Taube
Chronic obstructive pulmonary disease (COPD) patients experience the morning as the worst period of the day. Nevertheless, morning symptoms are not mentioned in COPD guidelines. Areas covered: Different topics on morning symptoms are covered in this review to underline their importance: occurrence, tools for assessment and therapies to limit morning symptoms. Expert Commentary: Morning symptoms are common and have a negative influence on a patient's life. Pharmacotherapy seems to be effective in decreasing morning symptoms...
March 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28276136/initial-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-in-australia-views-from-the-coal-face
#12
Bonnie Bereznicki, Haydn Walters, Julia Walters, Gregory Peterson, Luke Bereznicki
BACKGROUND: Early diagnosis and management can mitigate the long-term morbidity and mortality of chronic obstructive pulmonary disease (COPD). AIM: To gain insights into the initial diagnostic process and early management of COPD by Australian general practitioners (GPs). METHODS: A random sample of Australian GPs was invited to complete a postal survey, which assessed familiarity with and use of contemporary practice guidelines, diagnostic criteria, and management preferences for COPD...
March 9, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28274527/long-term-safety-and-efficacy-of-combined-tiotropium-and-olodaterol-in-japanese-patients-with-chronic-obstructive-pulmonary-disease
#13
Masakazu Ichinose, Motokazu Kato, Ayako Takizawa, Wataru Sakamoto, Lars Grönke, Kay Tetzlaff, Yoshinosuke Fukuchi
BACKGROUND: The efficacy and safety of once-daily tiotropium+olodaterol (T+O) (2.5/5µg or 5/5µg) for treating chronic obstructive pulmonary disease (COPD) have been demonstrated in the large, multinational, randomized, Phase III studies TONADO(®) 1 and 2, which included 413 Japanese patients (~80 in each group). This study was conducted to supplement the TONADO(®) study data to assess long-term safety in ≥100 Japanese patients treated for 1 year in compliance with International Conference on Harmonisation guidelines...
March 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28265524/relationship-between-severity-classification-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-clinical-outcomes-in-hospitalized-patients
#14
Pedro J Marcos, Pilar Sanjuán, Arturo Huerta, Irene Nieto-Codesido, Lucía Ferreira-Gonzalez, Oriol Sibila, Marcos I Restrepo
BACKGROUND: Limited data are available regarding the impact of the potential validation of the Canadian Thoracic Society (CTS) guidelines recommendations in classifying patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in simple and complex. The aim of the present study was to assess the CTS recommendations regarding risk stratification on clinical outcomes among patients hospitalized with an AECOPD. METHODS: We developed a retrospective cohort study of patients admitted to one tertiary hospital with a diagnosis of AECOPD...
January 22, 2017: Curēus
https://www.readbyqxmd.com/read/28251670/retrospective-audit-of-antimicrobial-prescribing-practices-for-acute-exacerbations-of-chronic-obstructive-pulmonary-diseases-in-a-large-regional-hospital
#15
D J Brownridge, S T R Zaidi
WHAT IS KNOWN AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines...
March 1, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28246687/-multimorbidity-management-and-the-physician-s-daily-clinical-dilemma
#16
E Battegay, M Cheetham, B M Holzer, A Nowak, D Schmidt, S Rampini
About 20-25% of all persons and about 90% of all patients who are acutely hospitalized in internal medicine departments have multiple acute or chronic diseases. They are multimorbid. The encounter with multimorbid patients has become the most common situation in the health care system. Theoretically, multimorbidity results in an innumerable potential disease constellations. In addition, the likelihood of interactions between diseases (disease-disease interactions, DDI) and the complexity increases overproportionately with each additional disease...
February 28, 2017: Der Internist
https://www.readbyqxmd.com/read/28245825/predictors-of-correct-technique-in-patients-using-pressurized-metered-dose-inhalers
#17
Kyra Bartolo, Martin Balzan, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon, Stephen Montefort
BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical...
February 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28231655/-study-on-the-situation-of-drug-use-in-patients-with-chronic-obstructive-pulmonary-diseases-in-the-chinese-communities-of-large-cities
#18
T Xiao, X Y Chen, N Wang, Q Zhao, C W Fu, B Xu
Objectives: To understand the medication being used among patients with chronic obstructive pulmonary diseases (COPD) in Chinese communities of large cities. Methods: A cross-sectional survey was carried out in Beijing, Shanghai, Chengdu and Guangzhou with the total number as 678 COPD cases who were continuously recruited. Subjects were face-to-face interviewed using a structured questionnaire and with medical records checked at the same time. All data were double entered into a database under EpiData 3.1, and analyzed by SAS 9...
February 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28227079/a-clinical-study-of-short-term-sternal-photoplethysmography-recordings-from-patients-with-obstructive-airways-diseases
#19
Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Bo Belhage, Karsten Hoppe, Shadi S Chreiteh, Nassim Nabipour, Erik V Thomsen, Dorthe B Saadi
Traditionally, measurements of the oxygen saturation (SpO2) has been confound to the extremities. In this study, we therefore investigated the possibility for reliable estimation of clinically relevant SpO2 levels from photoplethysmography (PPG) obtained on the sternum of patients with obstructive airway diseases. We initiated the study with a calibration of a prototype sternal PPG sensor. In accordance with the ISO 80601-2-61:2011 guidelines, the calibration was conducted as a controlled desaturation study...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226405/comparative-effectiveness-of-long-acting-beta2-agonist-combined-with-a-long-acting-muscarinic-antagonist-or-inhaled-corticosteroid-in-chronic-obstructive-pulmonary-disease
#20
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
INTRODUCTION: Several dual bronchodilator fixed dose inhaler medications were recently approved for the treatment of chronic obstructive pulmonary disease (COPD). These products combine a long-acting beta2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA). In clinical trials, the separate mechanisms of the bronchodilators resulted in improved lung function. COPD treatment guidelines currently recommend combination LABA/LAMA as alternative therapy to combination LABA/ inhaled corticosteroid (ICS)...
February 22, 2017: Pharmacotherapy
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