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Copd re-exacerbation

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
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
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
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
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
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
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
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
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...
2016: Scientific Reports
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
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
Neil C Barnes, Raj Sharma, Sally Lettis, Peter M A Calverley
Identification of a biomarker that predicts response to inhaled corticosteroids (ICS) would help evaluate the risk/benefit profile of ICS in chronic obstructive pulmonary disease (COPD) and guide treatment.The ISOLDE study randomised 751 patients (mean post-bronchodilator forced expiratory volume in 1 s (FEV1) 1.4 L: 50% predicted normal) to fluticasone propionate 500 μg twice daily or placebo for 3 years, finding no difference in FEV1 rate of decline between treatments (p=0.16) and a significant reduction in median exacerbation rate with fluticasone propionate versus placebo (p=0...
May 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
M J E Chalder, C L Wright, K J P Morton, P Dixon, A R Daykin, S Jenkins, J Benger, J Calvert, A Shaw, C Metcalfe, W Hollingworth, S Purdy
BACKGROUND: Chronic Obstructive Pulmonary Disease is one of the commonest respiratory diseases in the United Kingdom, accounting for 10% of unplanned hospital admissions each year. Nearly a third of these admitted patients are re-admitted to hospital within 28 days of discharge. Whilst there is a move within the NHS to ensure that people with long-term conditions receive more co-ordinated care, there is little research evidence to support an optimum approach to this in COPD. This study aims to evaluate the effectiveness of introducing standardised packages of care i...
February 25, 2016: BMC Pulmonary Medicine
Mona Bafadhel, Neil J Greening, Theresa C Harvey-Dunstan, Johanna E A Williams, Michael D Morgan, Christopher E Brightling, Syed F Hussain, Ian D Pavord, Sally J Singh, Michael C Steiner
BACKGROUND: Patients with moderate exacerbations of COPD and the eosinophilic phenotype have better outcomes with prednisolone. Whether this outcome is similar in patients hospitalized with a severe exacerbation of COPD is unclear. We investigated the rate of recovery of eosinophilic and noneosinophilic exacerbations in patients participating in a multicenter randomized controlled trial assessing health outcomes in hospitalized exacerbations. METHODS: Patients were recruited at presentation to the hospital with an exacerbation of COPD...
August 2016: Chest
Mona Lärstad, Ann-Charlotte Almstrand, Per Larsson, Björn Bake, Sven Larsson, Evert Ljungström, Ekaterina Mirgorodskaya, Anna-Carin Olin
BACKGROUND: Exhaled, endogenous particles are formed from the epithelial lining fluid in small airways, where surfactant protein A (SP-A) plays an important role in pulmonary host defense. Based on the knowledge that chronic obstructive pulmonary disease (COPD) starts in the small airway epithelium, we hypothesized that chronic inflammation modulates peripheral exhaled particle SP-A and albumin levels. The main objective of this explorative study was to compare the SP-A and albumin contents in exhaled particles from patients with COPD and healthy subjects and to determine exhaled particle number concentrations...
2015: PloS One
Javier de Miguel-Díez, Rodrigo Jiménez-García, Valentín Hernández-Barrera, Pilar Carrasco-Garrido, Luis Puente Maestu, Laura Ramírez García, Ana López de Andrés
BACKGROUND AND OBJECTIVE: Hospitalizations are not isolated events in COPD patients. A significant percentage of patients are readmitted during the first month after their discharge. The aim of this study was to elucidate changes in the incidence, comorbidity, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) of patients readmitted following an initial hospitalization by acute exacerbation of COPD (AE-COPD). METHODS: We selected all patients ≥40 years, hospitalized for AE-COPD between 2006 and 2012 in Spain using the National Hospital Discharge Database...
April 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Pingdong Li, Yucui Gong, Guangqiao Zeng, Liang Ruan, Guifen Li
OBJECTIVE: This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients. METHODS: We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups...
2015: International Journal of Clinical and Experimental Medicine
Gajanan S Gaude, B P Rajesh, Alisha Chaudhury, Jyothi Hattiholi
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disorder (AECOPD) are known to be associated with increased morbidity and mortality and have a significant socioeconomic impact. The factors that determine frequent hospital readmissions for AECOPD are poorly understood. The present study was done to ascertain failures rates following AECOPD and to evaluate factors associated with frequent readmissions. MATERIALS AND METHODS: We conducted a prospective study among 186 patients with COPD with one or more admissions for acute exacerbations in a tertiary care hospital...
September 2015: Lung India: Official Organ of Indian Chest Society
Hakan Gunen, Mehmet Yilmaz, Oguz Aktas, Pinar Ergun, Mediha Gonenc Ortakoylu, Atike Demir, Pelin Cetinkaya, Alev Gurgun, Muge Otlu, Aykut Cilli, Ufuk Yilmaz, Nurdan Kokturk, Ipek Candemir, Halil Ibrahim Yakar, Idilhan Ar, Aylin Konya
OBJECTIVE: To determine distribution of COPD assessment categories and physicians' adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 strategy in Turkish COPD patients. METHODS: A total of 1,610 COPD patients (mean [standard deviation] age: 62.6 [9.9] years, 85.7% were males) were included in this multicenter, non-interventional, cross-sectional study. Patients were categorized via GOLD 2013 strategy document. Consistency between reported and re-classified GOLD categories, and measures used for symptom evaluation and exacerbation was analyzed...
2015: International Journal of Chronic Obstructive Pulmonary Disease
Huong Q Nguyen, Adrienne Bailey, Karen J Coleman, Smita Desai, Vincent S Fan, Michael K Gould, Leah Maddock, Kimberly Miller, William Towner, Anny H Xiang, Marilyn L Moy
BACKGROUND: Physical inactivity is significantly associated with more frequent hospitalizations and increased mortality in COPD even after adjusting for disease severity. While practice guidelines recommend regular physical activity for all patients with COPD, health systems are challenged in operationalizing an effective and sustainable approach to assist patients in being physically active. METHODS: A pragmatic randomized controlled trial design was used to determine the effectiveness of a 12-month home and community-based physical activity coaching intervention (Walk On!) compared to standard care for 1650 patients at high risk for COPD exacerbations from a large integrated health care system...
January 2016: Contemporary Clinical Trials
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