Understanding the Gaps in the Reporting of COPD Exacerbations by Patients: A Review

COPD Journal of Chronic Obstructive Pulmonary Disease, Год журнала: 2024, Номер 21(1)

Опубликована: Фев. 29, 2024

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss lung function, poor quality life, exercise capacity, risk serious cardiovascular events, hospitalization, and death. However, patients underreport exacerbations, evidence suggests that unreported exacerbations have similar negative health implications for as those reported. Whilst there is guidance physicians to identify who at they do not help recognise report them. Newly developed tools, such the COPD Exacerbation Recognition Tool (CERT) been designed achieve this objective. This review focuses on underreporting by patients, factors this, consequences underreporting, potential solutions.

Язык: Английский

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Association between Increased Risk of Pneumonia with ICS in COPD: A Continuous Variable Analysis of Patient Factors from the IMPACT Study

Pulmonary Therapy, Год журнала: 2024, Номер 10(2), С. 183 - 192

Опубликована: Март 6, 2024

Despite the proven benefits of inhaled corticosteroid (ICS)-containing triple therapy for chronic obstructive pulmonary disease (COPD), clinicians limit patient exposure to ICS due risk pneumonia. However, there are multiple factors associated with pneumonia in patients COPD. This post hoc analysis IMPACT trial data aims set risks into a context specific patient-related that contribute The 52-week, double-blind randomized symptomatic COPD and ≥1 exacerbation prior year 2:2:1 once-daily fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI), FF/VI or UMEC/VI. Annual rate on-treatment pneumonias intent-to-treat population age, body mass index (BMI), percent predicted forced expiratory volume 1 s (FEV1) blood eosinophil count (BEC) was evaluated. revealed annual showed lowest at age 50 years. 95% confidence intervals (CI) between ICS-containing non-ICS containing treatments diverged ages > 63 years, suggesting significantly increased ICS-related older patients. In contrast, rose both groups below BMI 22.5 kg/m2, but above that, no relationship differential effect two groups. BEC flat up 300/µL cells treatment then rose. appeared increase lower level (~ 200/µL). There little evidence BMI, FEV1 on treatments. points need balanced approach versus benefit use ClinicalTrials.gov number, NCT02164513.

Язык: Английский

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A Delphi Consensus Project to Capture Greek Experts’ Opinion on the Position of Triple Therapies in COPD: Why, When and to Whom

International Journal of COPD, Год журнала: 2025, Номер Volume 20, С. 457 - 471

Опубликована: Фев. 1, 2025

In recent years, COPD treatment has become more personalized considering specific patient's characteristics. We have performed a DELPHI consensus project to assess the level of among Greek experts on use triple therapy in as an initial and follow-up treatment. A three-round Delphi online survey was developed. The questionnaire developed by 6-member steering committee, included 54 statements, divided into 3 domains: (A) (divided subdomains examining impact exacerbations based lung function, bronchodilation reversibility and/or blood eosinophil count, smoking, symptoms, comorbidities), (B) escalation from dual (C) de-escalation bronchodilation. funded AstraZeneca hosted analysed independent external company. Consensus reached 84.8%, 63% 80% statements for domains A, B C, respectively. Experts agreed that with is reasonable option patients, while could be considered, besides frequent exacerbators, also patients history one moderate exacerbation, mainly presence marked bronchodilator or high count. Finally, there inappropriate who had experienced exacerbation previous year. Although generated several panelists failed reach many aspects therapy, identifying areas further research.

Язык: Английский

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POTENTIAL DRUG DELIVERY SYSTEMS AND DEVICE COMBINATION FOR THE MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

International Journal of Applied Pharmaceutics, Год журнала: 2025, Номер unknown, С. 1 - 11

Опубликована: Март 7, 2025

Chronic Obstructive Pulmonary Disease (COPD) presents with chronic lung inflammation and poorly reversible airflow limitation, necessitating bronchodilators for management. The Global Initiative COPD recommends combining Long-Acting Beta-Agonists (LABAs) Antimuscarinic Agents (LAMAs) most patients. Developing fixed LAMA/lABA combinations is crucial. Adding an Inhaled Corticosteroid (ICS) to this combination may offer additional benefits, including preventing exacerbations. GOLD report emphasizes diagnosis, prevention, exacerbation management, addressing comorbidities. It advocates holistic integrating pharmacologic non-pharmacologic approaches. Novel strategies like mono, dual, triple therapies are recommended. review highlights COPD's impact on COVID-19, comorbidities, relevant patents concerning bronchodilators. bronchodilator treatments improve their efficacy in critical aspect of COPD. Research shows that dual bronchodilation improves function symptoms more consistently than mono-bronchodilation while potentially lowering the risk exacerbations disease deterioration having a similar safety profile.

Язык: Английский

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Delphi Consensus on Clinical Applications of GOLD 2023 Recommendations in COPD Management: How Aligned are Recommendations with Clinical Practice?

Pulmonary Therapy, Год журнала: 2023, Номер 10(1), С. 69 - 84

Опубликована: Дек. 19, 2023

The objective of this Delphi study was to understand and assess the level consensus among respiratory experts on clinical application GOLD 2023 recommendations in management patients with chronic obstructive pulmonary disease (COPD). comprised two online surveys a participant meeting 34 from 16 countries. Responses 73 questions were recorded using Likert scale ranging 0 (disagreement) 9 (agreement). threshold 75%. Survey 1 survey 2 had 32 participants, respectively; 25 attended meeting. Consensus reached 1: 28/42; 2: 18/30 close-ended questions. A relevance most updates definitions diagnosis COPD. Mixed results for treatment by noted: 74% agreed recommendation initiate dual bronchodilators group E patients; 63% including inhaled corticosteroids (ICS)/long-acting β2 agonist(LABA)/ Long-acting muscarinic receptor antagonists (LAMA) as option B patients. Also, lacked removing ICS + LABA an initial therapeutic option, countries challenges access other option;. 88% that they use their daily practice. This demonstrated high regarding key concepts report, participants favoring recent definitions, diagnosis, management, prevention More evidence etiotype based options are required which could further strengthen report. goal alignment changes proposed report routine practice There study, (primarily focused developing countries) invited participate. Using method, expert representatives shared insights aim optimizing patient care. assessed six well-defined themes: 1) Overall view GOLD/other recommendations; 2) Assessing COPD; 3) Initial pharmacological 4) Vaccination 5) Follow-up 6) Survival Participants expressed agreement them agreeing also highlighted need publish reports multiple languages shorter, pocket-sized format increase awareness adaptation healthcare providers.

Язык: Английский

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A clinician’s guide to single vs multiple inhaler therapy for COPD

Expert Review of Respiratory Medicine, Год журнала: 2024, Номер 18(7), С. 457 - 468

Опубликована: Июль 2, 2024

In the management of chronic obstructive pulmonary disease (COPD), inhalation therapy plays a pivotal role. However, clinicians often face dilemma choosing between single and multiple inhaler therapies for their patients. This choice is critical because it can affect treatment efficacy, patient adherence, overall management.

Язык: Английский

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Improving the Transparency and Replicability of Consensus Methods: Respiratory Medicine as a Case Example

Pragmatic and Observational Research, Год журнала: 2024, Номер Volume 15, С. 201 - 207

Опубликована: Окт. 1, 2024

Язык: Английский

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