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Copd re-exacerbation

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https://www.readbyqxmd.com/read/29099607/comparison-of-2017-and-2015-global-initiative-for-obstructive-lung-disease-impact-on-grouping-and-outcomes
#1
Carlos Cabrera López, Ciro Casanova Macario, José María Marín Trigo, Juan P de-Torres, Rebeca Sicilia Torres, Jesús María González, Francesca Polverino, Miguel Divo, Victor Pinto Plata, Javier J Zulueta, Bartolomé Celli
INTRODUCTION: The GOLD document has modified the grading system directing pharmacotherapy. But how this relates to the previous one of 2015 and to comorbidities, hospitalizations and mortality risk is unknown. METHODS: We prospectively enrolled and followed for a mean of 5 years, 819 COPD patients (84% male) in clinics in Spain and the United States. We determined anthropometrics, lung function (FEV1%), dyspnea score (mMRC), ambulatory and hospital exacerbations, the BODE and Charlson indexes...
November 3, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28810909/a-multi-center-randomized-controlled-open-label-trial-evaluating-the-effects-of-eosinophil-guided-corticosteroid-sparing-therapy-in-hospitalised-patients-with-copd-exacerbations-the-cortico-steroid-reduction-in-copd-cortico-cop-study-protocol
#2
Pradeesh Sivapalan, Mia Moberg, Josefin Eklöf, Julie Janner, Jørgen Vestbo, Rasmus Rude Laub, Andrea Browatzki, Karin Armbruster, Jon Torgny Wilcke, Niels Seersholm, Ulla Møller Weinreich, Ingrid Louise Titlestad, Helle Frost Andreassen, Charlotte Suppli Ulrik, Uffe Bødtger, Thyge Lynghøj Nielsen, Ejvind Frausing Hansen, Jens Ulrik Stæhr Jensen
BACKGROUND: The most commonly applied treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a 5-day course of high-dose systemic corticosteroids. However, this treatment has not been shown to reduce mortality and can potentially have serious side effects. Recent research has shown that, presumably, only a subgroup of COPD patients identifieable by blood eosinophil count benefit from a rescue course of prednisolone. By applying a biomarker-guided strategy, the aim of this study is to determine whether it is possible to reduce the use of systemic corticosteroids in AECOPD without influencing the outcome...
August 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28719228/successful-use-of-noninvasive-ventilation-in-chronic-obstructive-pulmonary-disease-how-do-high-performing-hospitals-do-it
#3
Kimberly A Fisher, Kathleen M Mazor, Sarah Goff, Mihaela S Stefan, Penelope S Pekow, Lauren A Williams, Vida Rastegar, Michael B Rothberg, Nicholas S Hill, Peter K Lindenauer
RATIONALE: Noninvasive ventilation (NIV) is a cornerstone of treatment for patients with severe exacerbations of chronic obstructive pulmonary disease (COPD), where it has been shown to reduce the need for intubation, hospital length of stay, and mortality. Despite high-quality evidence and strong recommendations in clinical guidelines, use of NIV varies widely across hospitals. OBJECTIVES: To identify approaches used by hospitals that have been successful in implementing NIV to treat patients with severe exacerbations of COPD...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28634972/predictors-of-re-exacerbation-after-an-index-exacerbation-of-chronic-obstructive-pulmonary-disease-in-the-reduce-randomised-clinical-trial
#4
Brigitte Engel, Christian Schindler, Jörg D Leuppi, Jonas Rutishauser
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) compromise physical activity and quality of life and contribute significantly to health care costs. Systemic glucocorticoids benefit clinical outcome in AECOPD, and the REDUCE trial demonstrated noninferiority of a 5-day treatment course with prednisone compared with 14 days therapy regarding clinical outcome over 6 months of follow-up. Unexpectedly, we found an inverse correlation between circulating cortisol levels and exacerbation risk during a 6-month follow-up period...
June 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28123293/inverse-relationship-between-nonadherence-to-original-gold-treatment-guidelines-and-exacerbations-of-copd
#5
Hussein D Foda, Anthony Brehm, Karen Goldsteen, Norman H Edelman
BACKGROUND: Prescriber disagreement is among the reasons for poor adherence to COPD treatment guidelines; it is yet not clear whether this leads to adverse outcomes. We tested whether undertreatment according to the original Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines led to increased exacerbations. METHODS: Records of 878 patients with spirometrically confirmed COPD who were followed from 2005 to 2010 at one Veterans Administration (VA) Medical Center were analyzed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27912934/effect-of-sequential-treatment-with-tcm-syndrome-differentiation-on-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-aecopd-risk-window
#6
RANDOMIZED CONTROLLED TRIAL
Li Jiansheng, Wang Haifeng, Li Suyun, Zhang Hailong, Yu Xueqing, Zhang Xiaoyun, Li Fengsen, Zhou Xianmei, Sun Zikai, Mao Yimin, Ma Lijun, Zhang Yijie, Zhang Guojun, Tang Bingxiang
OBJECTIVE: To evaluate the efficacy and safety of the comprehensive interventions based on three Traditional Chinese medicine (TCM) patterns therapy in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and AECOPD risk window. METHODS: A prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment. A total of 364 patients were enrolled into this study with 182 in each treatment group (TCM and conventional)...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27899531/a-respiratory-therapist-disease-management-program-for-subjects-hospitalized-with-copd
#7
RANDOMIZED CONTROLLED TRIAL
Patty C Silver, Marin H Kollef, Darnetta Clinkscale, Peggy Watts, Robin Kidder, Brittany Eads, Debbie Bennett, Carolyn Lora, Michael Quartaro
BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27860342/compliance-with-a-copd-bundle-of-care-in-an-australian-emergency-department-a-cohort-study
#8
Alexis Gerber, Catriona Moynihan, Sharon Klim, Peter Ritchie, Anne-Maree Kelly
INTRODUCTION: Bundles of care are gaining popularity for treating acute severe illness. OBJECTIVE: To describe compliance with bundle of care elements (individually and as a "bundle") for patients treated for chronic obstructive pulmonary disease (COPD) exacerbations in the emergency department (ED). METHODS: Retrospective observational study of patients presenting in the 2014 calendar year with an ED diagnosis of COPD. The primary outcomes of interest were compliance with key bundle of care elements (individually and as a "bundle")...
November 18, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27795984/pulmonary-predictors-of-incident-diabetes-in-smokers
#9
Gregory L Kinney, Emma H Baker, Oana L Klein, Jennifer L Black-Shinn, Emily S Wan, Barry Make, Elizabeth Regan, Russell P Bowler, Sharon M Lutz, Kendra A Young, Lindsey M Duca, George R Washko, Edwin K Silverman, James D Crapo, John E Hokanson
BACKGROUND: Diabetes mellitus and its complications are a large and increasing burden for health care worldwide. Reduced pulmonary function has been observed in diabetes (both type 1 and type 2), and this reduction is thought to occur prior to diagnosis. Other measures of pulmonary health are associated with diabetes, including lower exercise tolerance, greater dyspnea, lower quality of life (as measured by the St. George's Respiratory Questionaire [SGRQ]) and susceptibility to lung infection and these measures may also predate diabetes diagnosis...
2016: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/27727891/reducing-frequent-re-admissions-of-acute-exacerbation-of-copd-a-stitch-in-time-saves-nine
#10
Sivaraman A, Maniram Kumhar, Subash Saini, Manoj Mali, Gaurav Meratwal
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27692148/a-pilot-study-to-monitor-changes-in-spirometry-and-lung-volume-following-an-exacerbation-of-chronic-obstructive-pulmonary-disease-copd-as-part-of-a-supported-discharge-program
#11
Breda Cushen, Niamh McCormack, Kerrie Hennigan, Imran Sulaiman, Richard W Costello, Brenda Deering
BACKGROUND: One-third of patients with an exacerbation of Chronic Obstructive Pulmonary Disease(COPD) are re-hospitalised at 90 days. Exacerbation recovery is associated with reductions in lung hyperinflation and improvements in symptoms and physical activity. We assessed the feasibility of monitoring these clinical parameters in the home. We hypothesised that the degree of change in spirometry and lung volumes differs between those who had an uneventful recovery and those who experienced a further exacerbation...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27578467/impact-of-community-pharmacists-in-copd-management-inhalation-technique-and-medication-adherence
#12
REVIEW
Iman Hesso, Shereen Nabhani Gebara, Reem Kayyali
BACKGROUND: Inhalation technique and medication adherence are highly important for the management of chronic obstructive pulmonary disease (COPD) since they are essential pre-requisites for achieving full therapeutic effect in patients. Community pharmacists are in the best position to deliver services in these two areas. METHODS: This is a ten-year period review of studies looking into the impact of community pharmacists in the management of COPD in relation to: inhalation technique and medication adherence in the period from 2005 to 2015...
September 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27574416/effects-of-roflumilast-in-copd-patients-receiving-inhaled-corticosteroid-long-acting-%C3%AE-2-agonist-fixed-dose-combination-re-2-spond-rationale-and-study-design
#13
RANDOMIZED CONTROLLED TRIAL
Stephen I Rennard, Fernando J Martinez, Klaus F Rabe, Sanjay Sethi, Emilio Pizzichini, Andrew McIvor, Shahid Siddiqui, Antonio Anzueto, Haiyuan Zhu
BACKGROUND: Roflumilast, a once-daily, selective phosphodiesterase-4 inhibitor, reduces the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. The RE(2)SPOND study is examining whether roflumilast, when added to an inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fixed-dose combination (FDC), further reduces exacerbations. The methodology is described herein. METHODS: In this Phase IV, multicenter, double-blind, placebo-controlled, parallel-group trial, participants were randomized 1:1 (stratified by long-acting muscarinic antagonist use) to receive roflumilast or placebo, plus ICS/LABA FDC, for 52 weeks...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27311900/effect-of-a-hospital-outreach-intervention-programme-on-decreasing-hospitalisations-and-medical-costs-in-patients-with-chronic-obstructive-pulmonary-disease-in-china-protocol-of-a-randomised-controlled-trial
#14
Jin Yan, Lianhong Wang, Chun Liu, Hong Yuan, Xiaowan Wang, Baorong Yu, Qian Luo
INTRODUCTION: Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China...
2016: BMJ Open
https://www.readbyqxmd.com/read/27256252/natural-history-and-risk-stratification-of-patients-undergoing-non-invasive-ventilation-in-a-non-icu-setting-for-severe-copd-exacerbations
#15
Pier Paolo Sainaghi, Davide Colombo, Azzurra Re, Mattia Bellan, Daniele Sola, Piero Emilio Balbo, Mauro Campanini, Francesco Della Corte, Paolo Navalesi, Mario Pirisi
Non-invasive ventilation (NIV) delivered in an intensive care unit (ICU) has become the cornerstone in the treatment of patients with severe chronic obstructive pulmonary disease (COPD) exacerbations. A trend towards managing these patients in non-ICU setting has emerged in recent years, although out-of-hospital survival by this approach and how to prognosticate it is unknown. We aimed to investigate these issues. We consecutively recruited 100 patients (49 males; median age 82 years) who received NIV treatment for acute respiratory failure due to COPD exacerbation in non-ICU medical wards of our hospital, between November 2008 and July 2012...
October 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27167208/copd-readmissions-addressing-copd-in-the-era-of-value-based-health-care
#16
REVIEW
Tina Shah, Valerie G Press, Megan Huisingh-Scheetz, Steven R White
Of those patients hospitalized for an exacerbation of COPD, one in five will require rehospitalization within 30 days. Many developed countries are now implementing policies to increase care quality while controlling costs for COPD, known as value-based health care. In the United States, COPD is part of Medicare's Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals for excess 30-day, all-cause readmissions after a hospitalization for an acute exacerbation of COPD, despite minimal evidence to guide hospitals on how to reduce readmissions...
October 2016: Chest
https://www.readbyqxmd.com/read/27058777/order-set-to-improve-the-care-of-patients-hospitalized-for-an-exacerbation-of-chronic-obstructive-pulmonary-disease
#17
Kirstin E Brown, Kara J Johnson, Beth M DeRonne, Connie M Parenti, Kathryn L Rice
RATIONALE: Physicians' adherence to prescribing evidence-based inpatient and outpatient therapies for chronic obstructive pulmonary disease (COPD) is low, and there is a paucity of information about the utility of admission order sets for patients with COPD exacerbations. OBJECTIVES: To determine if implementation of a locally designed, evidence-based, multidisciplinary computer physician order entry set in the electronic health record improves the quality of physician pharmacologic prescribing for patients hospitalized for COPD exacerbations...
June 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27029815/effectiveness-of-telemonitoring-in-patients-with-chronic-obstructive-pulmonary-disease-in-taiwan-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Te-Wei Ho, Chun-Ta Huang, Herng-Chia Chiu, Sheng-Yuan Ruan, Yi-Ju Tsai, Chong-Jen Yu, Feipei Lai
Chronic obstructive pulmonary disease (COPD) is the leading cause of death worldwide, and poses a substantial economic and social burden. Telemonitoring has been proposed as a solution to this growing problem, but its impact on patient outcome is equivocal. This randomized controlled trial aimed to investigate effectiveness of telemonitoring in improving COPD patient outcome. In total, 106 subjects were randomly assigned to the telemonitoring (n = 53) or usual care (n = 53) group. During the two months following discharge, telemonitoring group patients had to report their symptoms daily using an electronic diary...
March 31, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27027547/prulifloxacin-vs-levofloxacin-for-exacerbation-of-copd-after-failure-of-other-antibiotics
#19
Massimo Giusti, Francesco Blasi, Ido Iori, Antonino Mazzone, Francesco Sgambato, Cecilia Politi, Paola Colagrande, Annamaria Casali, Antonella Valerio, Gualberto Gussoni, Erminio Bonizzoni, Mauro Campanini
The chronic course and evolution of chronic obstructive pulmonary disease (COPD) is often characterized by periods of exacerbation of symptoms, which have a negative impact on the quality of life of patients, as well as on the evolution of COPD, and represent a significant cause of medical intervention and hospitalization. Very few data are available on the efficacy of rescue antibiotics in patients with acute exacerbation of COPD (AECOPD) unresponsive to previous treatment. The aim of this study was to evaluate the efficacy of two fluoroquinolones in AECOPD previously treated without success...
October 2016: COPD
https://www.readbyqxmd.com/read/26953637/health-coaching-and-chronic-obstructive-pulmonary-disease-rehospitalization-a-randomized-study
#20
RANDOMIZED CONTROLLED TRIAL
Roberto Benzo, Kristin Vickers, Paul J Novotny, Sharon Tucker, Johanna Hoult, Pamela Neuenfeldt, John Connett, Kate Lorig, Charlene McEvoy
RATIONALE: Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions. OBJECTIVES: To determine the effect of comprehensive health coaching on the rate of COPD readmissions. METHODS: A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either (1) motivational interviewing-based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or (2) usual care...
September 15, 2016: American Journal of Respiratory and Critical Care Medicine
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