Precision health: treating the individual patient with chronic obstructive pulmonary disease

2019 ◽  
Vol 210 (9) ◽  
pp. 424-428 ◽  
Author(s):  
Ma'en Obeidat ◽  
Mohsen Sadatsafavi ◽  
Don D Sin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Individual ◽  
Precision Health

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 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.

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.

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.

scholarly journals Fixed combination of vilanterol triphenatate/fluticasone furoate in the treatment of patients with bronchial asthma and chronic obstructive pulmonary disease: a literature review

2022 ◽  
pp. 72-78
Author(s):  
A. A. Viesel ◽  
I. Yu. Viesel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bronchial Asthma ◽  
Randomized Clinical Trials ◽  
Fixed Combination ◽  
Chronic Obstructive ◽  
Fluticasone Furoate ◽  
Obstructive Pulmonary Disease ◽  
Number Of Patients ◽  
The Individual

A review of the literature selected from russian and foreign electronic medical libraries devoted to the use of a fixed combination of fluticasone furoate with vilanterol triphenatate (FF/VI) in the respiratory tract using a metered-dose powder inhaler in bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) is presented. (DPI) Ellipt. The results of studies of each of  the  components devoted to their clinical efficacy and safety, and the  use of  FF / VI in  asthma  and COPD are presented. Comparative randomized clinical trials have shown the advantages of FF / VI over the individual components of this combination and over other drugs. This combination was especially effective in AD. The economic efficiency of the transition of BA patients from everyday therapy to FF/VI has been proved. The data on the ability of the Ellipt DPI to form a clinically significant portion of the respirable fraction of both drugs, as well as data on the intuitive use of the device and adherence to the prescribed therapy are presented. In terms of the development of adverse events, the use of this combination in AD did not differ from placebo. With the use of FF/VI in patients with COPD, an increased incidence of pneumonia was noted, which was also typical for the use of FF alone, but did not accompany treatment with vilanterol. The analysis of the literature data based on well-planned multicenter RCTs with a large number of patients showed that the expansion of the use of a fixed combination of FF/VI in AD and COPD can improve control over these diseases and reduce the costs of practical healthcare, as well as preserve the level of treatment safety in comparison with monotherapy.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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