scholarly journals Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)—Current Considerations for Clinical Practice

2019 ◽  
Vol 8 (1) ◽  
pp. 69 ◽  
Author(s):  
Frederik Trinkmann ◽  
Joachim Saur ◽  
Martin Borggrefe ◽  
Ibrahim Akin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidities ◽  
Disease Entities ◽  
Considerable Morbidity ◽  
The Individual ◽  
Shared Risk ◽  
Current Guidelines

In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a “cardiopulmonary continuum” rather than being simply attributed to shared risk factors such as cigarette smoking. Overlapping symptoms such as dyspnea or chest pain lead to a worse prognosis due to missed concomitant diagnoses. Moreover, medication is often withheld as a result of unfounded concerns about side effects. Despite the frequent coincidence, current guidelines are still mostly restricted to the management of the individual disease. Future diagnostic and therapeutic strategies should therefore be guided by an integrative perspective as well as a refined phenotyping of disease entities.

Chronic obstructive pulmonary disease (COPD)

2021 ◽  
pp. 235-284
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Management Strategies ◽  
Airflow Obstruction ◽  
Assisted Ventilation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Considerable Morbidity ◽  
The Individual ◽  
Causes And Risk Factors

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder that causes considerable morbidity and mortality throughout the world. COPD is predominantly caused by smoking. COPD is characterized by fixed airflow obstruction. Significant airflow obstruction may be present before the individual is aware of it. Airflow obstruction is slowly progressive, with minimal or no reversibility to bronchodilators. This chapter covers the causes and risk factors, epidemiology, investigations, differential diagnosis, and assessment. It then goes on to describe management strategies (pharmacotherapy, drug delivery systems, other therapies), the management and treatment of acute exacerbations of COPD, oxygen, and assisted ventilation, the role of the nurse and the nurse specialist, complications, and palliative care.

Self-management support preferences of people with asthma or chronic obstructive pulmonary disease: A systematic review and meta-synthesis of qualitative studies

2019 ◽  
pp. 174239531986944 ◽  
Author(s):  
Selena O’Connell ◽  
Vera JC McCarthy ◽  
Eileen Savage
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Healthcare Professionals ◽  
Qualitative Studies ◽  
Self Management ◽  
Chronic Obstructive ◽  
Management Support ◽  
Obstructive Pulmonary Disease ◽  
The Individual ◽  
Behavioural Sciences

Objectives To synthesise findings from qualitative studies on the preferences of people with asthma or chronic obstructive pulmonary disease (COPD) for self-management support. Methods A thematic synthesis of literature was carried out. Six databases (ASSIA, CINAHL, MEDLINE, PsycINFO, Psychology and the Behavioural Sciences and SSCI) were used to search for qualitative studies eliciting perspectives of adults with asthma and/or COPD on self-management support, published between May 2008 and April 2018. Results A total of 968 articles were retrieved across databases, with 15 articles included in the synthesis. Three themes were identified: Types of Support described the range of supports valued by participants in the studies, particularly education provided by competent healthcare professionals; The Support Relationship highlighted the importance of a collaborative relationship with one’s healthcare professional which was characterised by communication, trust and continuity over time and Accessibility identified the considerations of participants relating to physically accessible, prompt support which is provided in a format preferred by the individual. Discussion Increased understanding of patients’ preferences may provide insight which can be used to enhance engagement with self-management support. Further research needs to examine self-management support preferences outside the context of evaluating interventions for people with asthma/COPD and needs to address the optimal means of enhancing accessibility.

scholarly journals Comparison of cerebral blood flow in subjects with and without chronic obstructive pulmonary disease from the population-based Rotterdam Study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053671
Author(s):  
Sara R A Wijnant ◽  
Daniel Bos ◽  
Guy Brusselle ◽  
Maxim Grymonprez ◽  
Ernst Rietzschel ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Pulmonary Disease ◽  
Population Based ◽  
Chronic Obstructive ◽  
Rotterdam Study ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidities ◽  
Cerebral Mri

ObjectivesPatients with chronic obstructive pulmonary disease (COPD) are at increased risk of cerebrovascular disease, which might be associated with decreases in cerebral blood flow. Since studies examining cerebral blood flow in COPD remain scarce and are limited by sample size, we aimed to study cerebral blood flow in participants with and without COPD.DesignObservational cohort study.SettingPopulation-based Rotterdam Study.Participants4177 participants (age 68.0±8.5 years; 53% females) with and without COPD.Predictor variableSpirometry and pulmonary diffusing capacity.Outcome measuresCerebral blood flow by two-dimensional phase-contrast cerebral MRI.ResultsCompared with subjects with normal spirometry (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7 and FEV1 ≥80%), multivariable adjusted cerebral blood flow (mL/min) was preserved in subjects with COPD Global initiative for Chronic Obstructive Lung Disease (GOLD1) (FEV1/FVC <0.7 and FEV1 ≥80%), but significantly lower in subjects with COPD GOLD2-3 (FEV1/FVC <0.7 and FEV1 <80%), even after adjustment for cardiovascular comorbidities. In sex-stratified analyses, this difference in cerebral blood flow was statistically significant in women but not in men. Cerebral blood flow was lowest in subjects with FEV1, FVC and diffusion lung capacity for carbon monoxide % predicted values in the lowest quintile, even after adjustment for cardiovascular comorbidities and cardiac function.ConclusionWe observed a lowered cerebral blood flow in subjects with COPD GOLD2-3.

Therapy-related issues: respiratory system

2017 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory System ◽  
Asthma Management ◽  
British National Formulary ◽  
Chronic Obstructive ◽  
National Formulary ◽  
Obstructive Pulmonary Disease ◽  
System P ◽  
Current Guidelines

This chapter outlines information relevant to clinical pharmacists related to respiratory system issues and is loosely based on the British National Formulary, Chapter 3. In particular, this chapter covers current guidelines on asthma management, including a section on inhaler techniques for different products, and management of stable chronic obstructive pulmonary disease.

scholarly journals Healthcare Costs of Patients With Chronic Obstructive Pulmonary Disease in Denmark – Hospital Treated Versus Primary Care Only

2021 ◽  
Author(s):  
Jesper Lykkegaard ◽  
Jesper Bo Nielsen ◽  
Maria Munch Storsveen ◽  
Dorte Ejg Jarbøl ◽  
Jens Søndergaard
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Secondary Care ◽  
Healthcare Costs ◽  
Hospital Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
And Gender ◽  
The Individual

Abstract Background: Many patients are treated for chronic obstructive pulmonary disease (COPD) in primary care but have never received COPD treatment in secondary care. They are seldom included in COPD cost studies but may account for a substantial proportion of the total costs.Objective: To estimate and specify the total healthcare costs of patients treated for COPD in Denmark comparing those who have- and have not had COPD treatment in secondary care.Setting: Denmark, population 5.7 million citizens.Methods: Via national registers, we specified the total healthcare costs of all +30-years-old current users of respiratory pharmaceuticals. We then compared those with at least one episode of hospital treatment for COPD (=secondary-care) to those with no hospital treatment for COPD but who redeem prescriptions specifically for COPD (=primary-care-only).Results: Among totally 329,428 users of respiratory drugs, we identified 46,084 with secondary-care- and 68,471 with primary-care-only COPD. Primary-care-only accounted for 40% of the two groups’ total healthcare costs. The age- and gender-adjusted coefficient relating the individual total costs secondary-care versus primary-care-only was 2.19. The individual costs ranged widely and overlapped considerably (p25-75: secondary-care 2,175€ - 12,625€, primary-care-only 1,110€ - 4,350€). Hospital treatment accounted for most of the total cost (secondary-care 78%, primary-care-only 62%; coefficient 2.81), pharmaceuticals (secondary-care 16%, primary-care-only 27%; coefficient 1.28), and primary care costs (secondary-care 6%, primary-care-only 11%; coefficient 1.13).Conclusion: Healthcare cost estimators and planners should consider the substantial volume of patients who are treated for COPD in primary care, but do not appear in hospital statistics.

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