Examining patients' preferences for participation in clinical decision-making: the experience in a Latin American chronic obstructive pulmonary disease and cancer outpatient population

2014 ◽  
Vol 44 (3) ◽  
pp. 281-287 ◽  
Author(s):  
P. Jordan ◽  
S. Quadrelli ◽  
M. Heres ◽  
L. Belli ◽  
N. Ruhl ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Decision Making ◽  
Pulmonary Disease ◽  
Latin American ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Clinical Decision-Making Tool for Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results From an Interdisciplinary Delphi Survey and Focus Groups

2015 ◽  
Vol 95 (10) ◽  
pp. 1387-1396 ◽  
Author(s):  
Pat G. Camp ◽  
W. Darlene Reid ◽  
Frank Chung ◽  
Ashley Kirkham ◽  
Dina Brooks ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Focus Groups ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Chronic Obstructive ◽  
Delphi Panel ◽  
Obstructive Pulmonary Disease

Background Exercise is recommended for people with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet there is little information to guide safe and effective mobilization and exercise for these patients. Objectives The purpose of this study was to develop a clinical decision-making tool to guide health care professionals in the assessment, prescription, monitoring, and progression of mobilization and therapeutic exercise for patients with AECOPD. Design and Methods A 3-round interdisciplinary Delphi panel identified and selected items based on a preselected consensus of 80%. These items were summarized in a paper-based tool titled Mobilization in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD-Mob). Focus groups and questionnaires were subsequently used to conduct a sensibility evaluation of the tool. Results Nine researchers, 13 clinicians, and 7 individuals with COPD identified and approved 110 parameters for safe and effective exercise in AECOPD. These parameters were grouped into 5 categories: (1) “What to Assess Prior to Mobilization,” (2) “When to Consider Not Mobilizing or to Discontinue Mobilization,” (3) “What to Monitor During Mobilization for Patient Safety,” (4) “How to Progress Mobilization to Enhance Effectiveness,” and (5) “What to Confirm Prior to Discharge.” The tool was evaluated in 4 focus groups of 18 health care professionals, 90% of whom reported the tool was easy to use, was concise, and would guide a health care professional who is new to the acute care setting and working with patients with AECOPD. Limitations The tool was developed based on published evidence and expert opinion, so the applicability of the items to patients in all settings cannot be guaranteed. The Delphi panel consisted of health care professionals from Canada, so items may not be generalizable to other jurisdictions. Conclusions The AECOPD-Mob provides practical and concise information on safe and effective exercise for the AECOPD population for use by the new graduate or novice acute care practitioner.

Diagnosing asthma and chronic obstructive pulmonary disease with machine learning

2017 ◽  
Vol 25 (3) ◽  
pp. 811-827 ◽  
Author(s):  
Dimitris Spathis ◽  
Panayiotis Vlamos
Keyword(s):  
Machine Learning ◽  
Chronic Obstructive Pulmonary Disease ◽  
Random Forest ◽  
Pulmonary Disease ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Forced Expiratory Volume ◽  
Random Forest Classifier ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

This study examines the clinical decision support systems in healthcare, in particular about the prevention, diagnosis and treatment of respiratory diseases, such as Asthma and chronic obstructive pulmonary disease. The empirical pulmonology study of a representative sample (n = 132) attempts to identify the major factors that contribute to the diagnosis of these diseases. Machine learning results show that in chronic obstructive pulmonary disease’s case, Random Forest classifier outperforms other techniques with 97.7 per cent precision, while the most prominent attributes for diagnosis are smoking, forced expiratory volume 1, age and forced vital capacity. In asthma’s case, the best precision, 80.3 per cent, is achieved again with the Random Forest classifier, while the most prominent attribute is MEF2575.

scholarly journals The Importance of Inhaler Adherence to Prevent COPD Exacerbations

2019 ◽  
Vol 7 (4) ◽  
pp. 54 ◽  
Author(s):  
Jose R Jardim ◽  
Oliver A. Nascimento
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Latin American ◽  
Real Life ◽  
Chronic Obstructive ◽  
Good Adherence ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Life Study ◽  
Copd Exacerbations

It has been shown that the better outcomes of chronic obstructive pulmonary disease (COPD) are closely associated with adherence to drug therapy, independent of the treatment administered. The clinical trial Towards a Revolution in COPD Health (TORCH) study clearly showed in a three year follow up that patients with good adherence to their inhaler treatment presented a longer time before the first exacerbation, a lower susceptibility to exacerbation and lower all-cause mortality. The Latin American Study of 24-hour Symptoms in Chronic Obstructive Pulmonary Disease (LASSYC), a real-life study, evaluated the self-reported inhaler adherence in COPD patients in seven countries in a cross-sectional non-interventional study and found that approximately 50% of the patients had good adherence, 30% moderate adherence and 20% poor adherence. Adherence to inhaler may be evaluated by the specific inhaler adherence questionnaire, the Test of Adherence to Inhalers (TAI). Several factors may predict the incorrect use of inhalers or adherence in COPD outpatient, including the number of devices and the daily dosing frequency. Ideally, patient education, simplicity of the device operation, the use of just one device for multiple medications and the best adaptation of the patient to the inhaler should guide the physician in prescribing the device.

scholarly journals Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Rationale and Methods for an Integrated Knowledge Translation Study

2013 ◽  
Vol 20 (4) ◽  
pp. 281-284 ◽  
Author(s):  
Pat G Camp ◽  
W Darlene Reid ◽  
Cristiane Yamabayashi ◽  
Dina Brooks ◽  
Donna Goodridge ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease

BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions.OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD.METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD.RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework.CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.

Treatment of Chronic Obstructive Pulmonary Disease in 5 Latin American Cities: The PLATINO Study

2008 ◽  
Vol 44 (2) ◽  
pp. 58-64 ◽  
Author(s):  
María Victorina López Varela ◽  
Adriana Muiño ◽  
Rogelio Pérez Padilla ◽  
José Roberto Jardim ◽  
Carlos Tálamo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Latin American ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
American Cities

scholarly journals Toward Optimal End-of-Life Care for Patients with Advanced Chronic Obstructive Pulmonary Disease: Insights from a Multicentre Study

2008 ◽  
Vol 15 (5) ◽  
pp. 249-254 ◽  
Author(s):  
Graeme M Rocker ◽  
Peter M Dodek ◽  
Daren K Heyland ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Decision Making ◽  
End Of Life ◽  
Pulmonary Disease ◽  
Life Support ◽  
Symptom Relief ◽  
Symptom Control ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Eol Care

BACKGROUND: Understanding patients’ needs and perspectives is fundamental to improving end-of-life (EOL) care. However, little is known of what quality care means to patients who have advanced lung disease.OBJECTIVES: To describe ratings of importance and satisfaction with elements of EOL care, informational needs, decision-making preferences, obstacles to a preferred location of death, clinical outcomes, and health care use before and during an index hospital admission for patients who have advanced chronic obstructive pulmonary disease (COPD).METHODS: A questionnaire with regard to quality EOL care was administered to patients older than 55 years of age who had advanced medical disease in five Canadian teaching hospitals.RESULTS: For 118 hospitalized patients who had advanced COPD, the following items were rated as extremely important for EOL care: not being kept alive on life support when there is little hope for meaningful recovery (54.9% of respondents), symptom relief (46.6%), provision of care and health services after discharge (40.0%), trust and confidence in physicians (39.7%), and not being a burden on caregivers (39.6%). Compared with patients who had metastatic cancer, patients with COPD had lower (P<0.05) satisfaction with care, interest in information about prognosis, cardiopulmonary resuscitation or mechanical ventilation, and referral rates to palliative care, whereas use of acute care services was higher (P<0.05) for patients who had advanced COPD.CONCLUSION: Canadian patients who have advanced COPD identify several priorities for improving care. Avoidance of prolonged or unwanted life support requires more effective communication, decision making and goal setting. Patients also deserve better symptom control and postdischarge strategies to minimize perceived burdens on caregivers, emergency room visits and hospital admissions.

Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study

The Lancet ◽  
2005 ◽  
Vol 366 (9500) ◽  
pp. 1875-1881 ◽  
Author(s):  
Ana Maria B Menezes ◽  
Rogelio Perez-Padilla ◽  
JoséRoberto B Jardim ◽  
Adriana Muiño ◽  
Maria Victorina Lopez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Latin American ◽  
Prevalence Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
American Cities
Sign in / Sign up

Export Citation Format

Share Document