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copd, breathlessness, primary care

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https://www.readbyqxmd.com/read/29217721/insights-from-australians-with-respiratory-disease-living-in-the-community-with-experience-of-self-managing-through-an-emergency-department-near-miss-for-breathlessness-a-strengths-based-qualitative-study
#1
Tim Luckett, Jane Phillips, Miriam Johnson, Maja Garcia, Priyanka Bhattarai, Virginia Carrieri-Kohlman, Anne Hutchinson, Rebecca T Disler, David Currow, Meera Agar, Serra Ivynian, Richard Chye, Phillip J Newton, Patricia M Davidson
OBJECTIVES: Breathlessness 'crises' in people with chronic respiratory conditions are a common precipitant for emergency department (ED) presentations, many of which might be avoided through improved self-management and support. This study sought insights from people with experience of ED 'near misses' where they considered going to the ED but successfully self-managed instead. DESIGN AND METHODS: A qualitative approach was used with a phenomenological orientation...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29021576/the-recording-and-characteristics-of-pulmonary-rehabilitation-in-patients-with-copd-using-the-health-information-network-thin-primary-care-database
#2
Ali Hakamy, Tricia M McKeever, Jack E Gibson, Charlotte E Bolton
Pulmonary rehabilitation is recommended for patients with COPD to improve physical function, breathlessness and quality of life. Using The Health Information Network (THIN) primary care database in UK, we compared the demographic and clinical parameters of patients with COPD in relation to coding of pulmonary rehabilitation, and to investigate whether there is a survival benefit from pulmonary rehabilitation. We identified patients with COPD, diagnosed from 2004 and extracted information on demographics, pulmonary rehabilitation and clinical parameters using the relevant Read codes...
October 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#3
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28872031/palliative-care-and-management-of-troublesome-symptoms-for-people-with-chronic-obstructive-pulmonary-disease
#4
REVIEW
Matthew Maddocks, Natasha Lovell, Sara Booth, William D-C Man, Irene J Higginson
People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care...
September 2, 2017: Lancet
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#5
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28617682/carers-and-breathlessness
#6
Morag Farquhar
PURPOSE OF REVIEW: Informal carers play a key role in supporting patients living with breathlessness in advanced disease, but with considerable impacts on their own well being. The purpose was to review recent advances in our understanding of the caring role in refractory breathlessness, its impacts on carers, and interventions to support them. RECENT FINDINGS: A systematic literature search resulted in 28 included articles that could be mapped to four broad areas of carer enquiry: the carer role (n = 6), role impact (n = 7), carer support (n = 11) and carer views (n = 4)...
September 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28459622/respiratory-symptoms-items-from-the-copd-assessment-test-identify-ever-smokers-with-preserved-lung-function-at-higher-risk-for-poor-respiratory-outcomes-an-analysis-of-the-subpopulations-and-intermediate-outcome-measures-in-copd-study-cohort
#7
Carlos H Martinez, Susan Murray, R Graham Barr, Eugene Bleecker, Russell P Bowler, Stephanie A Christenson, Alejandro P Comellas, Christopher B Cooper, David Couper, Gerard J Criner, Jeffrey L Curtis, Mark T Dransfield, Nadia N Hansel, Eric A Hoffman, Richard E Kanner, Eric Kleerup, Jerry A Krishnan, Stephen C Lazarus, Nancy K Leidy, Wanda O'Neal, Fernando J Martinez, Robert Paine, Stephen I Rennard, Donald P Tashkin, Prescott G Woodruff, MeiLan K Han
RATIONALE: Ever-smokers without airflow obstruction scores greater than or equal to 10 on the COPD Assessment Test (CAT) still have frequent acute respiratory disease events (exacerbation-like), impaired exercise capacity, and imaging abnormalities. Identification of these subjects could provide new opportunities for targeted interventions. OBJECTIVES: We hypothesized that the four respiratory-related items of the CAT might be useful for identifying such individuals, with discriminative ability similar to CAT, which is an eight-item questionnaire used to assess chronic obstructive pulmonary disease impact, including nonrespiratory questions, with scores ranging from 0 to 40...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28428155/using-persuasive-technology-to-increase-physical-activity-in-people-with-chronic-obstructive-pulmonary-disease-by-encouraging-regular-walking-a-mixed-methods-study-exploring-opinions-and-preferences
#8
Yvonne Kiera Bartlett, Thomas L Webb, Mark S Hawley
BACKGROUND: People with chronic obstructive pulmonary disease (PwCOPD) often experience breathlessness and fatigue, making physical activity challenging. Although many persuasive technologies (such as mobile phone apps) have been designed to support physical activity among members of the general population, current technologies aimed at PwCOPD are underdeveloped and only use a limited range of persuasive technology design principles. OBJECTIVE: The aim of this study was to explore how acceptable different persuasive technology design principles were considered to be in supporting and encouraging physical activity among PwCOPD...
April 20, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27932629/breathlessness-during-daily-activity-the-psychometric-properties-of-the-london-chest-activity-of-daily-living-scale-in-patients-with-advanced-disease-and-refractory-breathlessness
#9
Charles C Reilly, Claudia Bausewein, Rachel Garrod, Caroline J Jolley, John Moxham, Irene J Higginson
BACKGROUND: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. AIM: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. DESIGN: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034)...
October 2017: Palliative Medicine
https://www.readbyqxmd.com/read/27764523/benzodiazepines-for-the-relief-of-breathlessness-in-advanced-malignant-and-non-malignant-diseases-in-adults
#10
REVIEW
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27729780/prevalence-of-undiagnosed-airflow-obstruction-among-people-with-a-history-of-smoking-in-a-primary-care-setting
#11
MULTICENTER STUDY
Sau Nga Fu, Wai Cho Yu, Carlos King-Ho Wong, Margaret Choi-Hing Lam
PURPOSE: The purpose of this study was to define the prevalence of undiagnosed airflow obstruction (AO) among subjects with a history of smoking but no previous diagnosis of chronic lung disease. The finding of AO likely represents diagnosis of chronic obstructive pulmonary disease. PATIENTS: People aged ≥30 years with a history of smoking who attended public outpatient clinics for primary care services were included in this study. METHODS: A cross-sectional survey in five clinics in Hong Kong using the Breathlessness, Cough, and Sputum Scale, the Lung Function Questionnaire, and office spirometry was conducted...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/26733228/the-diagnosis-of-copd-in-primary-care-gender-differences-and-the-role-of-spirometry
#12
N J Roberts, I S Patel, M R Partridge
BACKGROUND: Females with exacerbations of Chronic Obstructive Pulmonary Disease now account for one half of all hospital admissions for that condition and rates have been increasing over the last few decades. Differences in presentations of disease between genders have been shown in several conditions and this study explores whether there are inter gender biases in probable diagnoses in those suspected to have COPD. METHODS: 445 individuals with a provisional diagnosis by their General Practitioner of "suspected COPD" or "definite COPD" were referred to a community Respiratory Assessment unit (CRAU) for tests including spirometry...
February 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/26345486/palliative-care-in-copd-an-unmet-area-for-quality-improvement
#13
REVIEW
Julia H Vermylen, Eytan Szmuilowicz, Ravi Kalhan
COPD is a leading cause of morbidity and mortality worldwide. Patients suffer from refractory breathlessness, unrecognized anxiety and depression, and decreased quality of life. Palliative care improves symptom management, patient reported health-related quality of life, cost savings, and mortality though the majority of patients with COPD die without access to palliative care. There are many barriers to providing palliative care to patients with COPD including the difficulty in prognosticating a patient's course causing referrals to occur late in a patient's disease...
2015: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/26070795/presentation-of-respiratory-symptoms-prior-to-diagnosis-in-general-practice-a-case-control-study-examining-free-text-and-morbidity-codes
#14
Richard A Hayward, Ying Chen, Peter Croft, Kelvin P Jordan
OBJECTIVE: General practitioners can record patients' presenting symptoms by using a code or free text. We compared breathlessness and wheeze symptom codes and free text recorded prior to diagnosis of ischaemic heart disease (IHD), chronic obstructive pulmonary disease (COPD) and asthma. DESIGN: A case-control study. SETTING: 11 general practices in North Staffordshire, UK, contributing to the Consultations in Primary Care Archive consultation database...
June 12, 2015: BMJ Open
https://www.readbyqxmd.com/read/25904448/a-changing-landscape-diagnosis-and-management-of-copd
#15
Steve Holmes, Jane Scullion
Chronic obstructive pulmonary disease (COPD) is a common and often particularly debilitating disease. Progressively worsening breathlessness can limit normal daily functioning, reduce quality of life (QoL) and increase the risk of premature death. Importantly, early diagnosis, improving symptoms and QoL, along with minimising exacerbations and hospital admissions, are primary goals of patient care. In recent years, the assessment of COPD has moved away from equating disease severity solely with the degree of obstructive lung impairment to include patient symptoms, exacerbation history and comorbidities, as well as smoking status...
April 23, 2015: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/25823440/new-scoring-system-for-the-differentiation-of-chronic-obstructive-pulmonary-disease-and-asthma
#16
Young Seok Lee, Seunghee Baek, Yousang Ko, Mi-Yeong Kim, Hyun-Kyung Lee, Tae-Bum Kim, You Sook Cho, Hee-Bom Moon, Sang-Do Lee, Yeon-Mok Oh
BACKGROUND AND OBJECTIVE: It remains difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinical practice, especially in a primary care setting. The purpose of this study was to develop a new scoring system for differentiating between COPD and asthma, and to evaluate its effectiveness. METHODS: First, to identify important variables differentiating COPD from asthma, the data of 197 patients with COPD and 138 patients with asthma were assessed retrospectively...
May 2015: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/25465642/an-integrated-palliative-and-respiratory-care-service-for-patients-with-advanced-disease-and-refractory-breathlessness-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Irene J Higginson, Claudia Bausewein, Charles C Reilly, Wei Gao, Marjolein Gysels, Mendwas Dzingina, Paul McCrone, Sara Booth, Caroline J Jolley, John Moxham
BACKGROUND: Breathlessness is a common and distressing symptom, which increases in many diseases as they progress and is difficult to manage. We assessed the effectiveness of early palliative care integrated with respiratory services for patients with advanced disease and refractory breathlessness. METHODS: In this single-blind randomised trial, we enrolled consecutive adults with refractory breathlessness and advanced disease from three large teaching hospitals and via general practitioners in South London...
December 2014: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/25255297/development-of-a-family-based-pulmonary-rehabilitation-programme-an-exploratory-study
#18
Alda Marques, Raquel Gabriel, Cristina Jácome, Joana Cruz, Dina Brooks, Daniela Figueiredo
PURPOSE: This study explored the expectations of patients with chronic obstructive pulmonary disease (COPD) and family members about a family-based pulmonary rehabilitation (PR) programme; developed and implemented a family-based PR programme and explored the impacts of the intervention on patients and family members. METHOD: Patients with COPD and family members were interviewed. A family-based PR programme was designed. Patients' breathlessness, muscle strength, exercise tolerance, functional balance and health-related quality of life were collected pre/post-programme...
2015: Disability and Rehabilitation
https://www.readbyqxmd.com/read/24780181/experience-of-advanced-chronic-obstructive-pulmonary-disease-metasynthesis-of-qualitative-research
#19
REVIEW
Rebecca T Disler, Anna Green, Tim Luckett, Phillip J Newton, Sally Inglis, David C Currow, Patricia M Davidson
CONTEXT: Chronic obstructive pulmonary disease (COPD) is a life-limiting illness. Despite best available treatments, individuals continue to experience symptom burden and have high health care utilization. OBJECTIVES: To increase understanding of the experience and ongoing needs of individuals living with COPD. METHODS: Medline, PsycINFO, CINAHL, and Sociological Abstracts were searched for articles published between January 1990 and June 2013...
December 2014: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/24600218/how-do-informal-self-care-strategies-evolve-among-patients-with-chronic-obstructive-pulmonary-disease-managed-in-primary-care-a-qualitative-study
#20
RANDOMIZED CONTROLLED TRIAL
Lindsay D Apps, Samantha L Harrison, Johanna E A Williams, Nicky Hudson, Michael Steiner, Mike D Morgan, Sally J Singh
BACKGROUND: There is much description in the literature of how patients with chronic obstructive pulmonary disease (COPD) manage their breathlessness and engage in self-care activities; however, little of this is from the perspective of those with less severe disease, who are primarily managed in primary care. This study aimed to understand the self-care experiences of patients with COPD who are primarily managed in primary care, and to examine the challenges of engaging in such behaviors...
2014: International Journal of Chronic Obstructive Pulmonary Disease
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