Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4007
T. Jackson, Elisabeth Ehrlich, K. McClatchey, Susan L. Morrow, Stephanie J. C. Taylor, H. Pinnock
{"title":"Involving patients in developing, refining and testing an implementation strategy to promote asthma self-management using the National Standards for Public Involvement","authors":"T. Jackson, Elisabeth Ehrlich, K. McClatchey, Susan L. Morrow, Stephanie J. C. Taylor, H. Pinnock","doi":"10.1183/13993003.congress-2019.pa4007","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4007","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114644970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa5019
K. Klester, E. Klester, V. Elykomov, A. Zharikov, Galina Ermachkova, M. Nikolaeva, E. Mukhtarova
Introduction: a problem of multi-morbidity - the increase in the multiplicity of diseases with age, which reflects, first of all, involutional processes and comorbidity - the deterministic possibility of their combination, is particularly difficult. Objective: to study gender characteristics of comorbid conditions and determine the degree of their influence on mortality in COPD. Materials and Methods: conducted a 6-year clinical observations in COPD p-s (n = 518; 389 were males, mean age - 66,2 ±13,9 years). The Carlson Comorbidity Index (CCI; 1987), the geriatric Cumulative Illness Rating Scale (CIRS-G), Barthel Index (BI) were evaluated. Results: CCI was in group A - 3,2 ± 1,1; in B - 3,8 ± 0,9; in C - 4,6 ± 1,0; in D - 3,9 ± 0,8 (all p 4 scores (odds ratio [OR] 4.92; 95% confidence interval [CI], 3.89-6.34; p Conclusion: Associated pathology forms a syndrome of mutual aggravation, which leads to an increased risk of death in the assessment by CCI with mandatory consideration of gender differences, which should be taken into account in the development of treatment plans for COPD patients.
{"title":"Gender aspect of comorbidities in COPD patients in primary care","authors":"K. Klester, E. Klester, V. Elykomov, A. Zharikov, Galina Ermachkova, M. Nikolaeva, E. Mukhtarova","doi":"10.1183/13993003.congress-2019.pa5019","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5019","url":null,"abstract":"Introduction: a problem of multi-morbidity - the increase in the multiplicity of diseases with age, which reflects, first of all, involutional processes and comorbidity - the deterministic possibility of their combination, is particularly difficult. Objective: to study gender characteristics of comorbid conditions and determine the degree of their influence on mortality in COPD. Materials and Methods: conducted a 6-year clinical observations in COPD p-s (n = 518; 389 were males, mean age - 66,2 ±13,9 years). The Carlson Comorbidity Index (CCI; 1987), the geriatric Cumulative Illness Rating Scale (CIRS-G), Barthel Index (BI) were evaluated. Results: CCI was in group A - 3,2 ± 1,1; in B - 3,8 ± 0,9; in C - 4,6 ± 1,0; in D - 3,9 ± 0,8 (all p 4 scores (odds ratio [OR] 4.92; 95% confidence interval [CI], 3.89-6.34; p Conclusion: Associated pathology forms a syndrome of mutual aggravation, which leads to an increased risk of death in the assessment by CCI with mandatory consideration of gender differences, which should be taken into account in the development of treatment plans for COPD patients.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128914926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa5153
J. Quint, C. O'Leary, A. Venerus, M. Myland, Nicholas Hudson, U. Holmgren, P. Varghese, H. Richter, G. Bizouard, C. Cabrera
Background: Maintenance treatment in COPD recommends triple therapy (TT), often following use of mono-or dual-therapy. We explored how pathways to TT vary across countries. Aims and Objectives: We investigated the proportion of patients on TT relative to the timing of their COPD diagnosis and the treatment pathway to TT including the time from diagnosis to initiation of TT and adherence. Methods: A retrospective cohort study was performed using anonymised patient-level data from UK, France, Germany, Italy, and Australia from 01/01/2005 to 01/05/2016. Patients were included if their first TT regimen was recorded during this period and they had ≥12 months data pre-index (COPD diagnosis). The proportion of patients on TT before COPD diagnosis was also determined. Treatment pathways and time to TT initiation following index were evaluated. Adherence to TT was estimated using proportion of days covered. Results: Overall 130,729 eligible patients were included. Mean age at diagnosis ranged from 63.4 (SD:10.4) years [pneumologist-treated in Germany] to 69.8 (9.9) years [Italy]. Time to TT ranged from median 16.9 months in Australia (IQR: 5.7 – 36.2) to 42.5 months in the UK (IQR: 13.9 -87.4). TT initiated first formed the largest treatment pathway (7.5% in UK to 17.1% in France). In meta-analyses of patients across all countries, 20.4% (95% CI: 13.8-29.1%) of patients initiated TT prior to COPD diagnosis. Estimated adherence was >80% in all countries during the time the patient was persistent with TT. Conclusions: Diverse patient pathways to TT were observed both between and within countries, many of which do not align with COPD treatment recommendations.
{"title":"Triple Therapy Pathways: A Multi-Country, Retrospective Observational Study in Chronic Obstructive Pulmonary Disease (COPD)","authors":"J. Quint, C. O'Leary, A. Venerus, M. Myland, Nicholas Hudson, U. Holmgren, P. Varghese, H. Richter, G. Bizouard, C. Cabrera","doi":"10.1183/13993003.congress-2019.oa5153","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa5153","url":null,"abstract":"Background: Maintenance treatment in COPD recommends triple therapy (TT), often following use of mono-or dual-therapy. We explored how pathways to TT vary across countries. Aims and Objectives: We investigated the proportion of patients on TT relative to the timing of their COPD diagnosis and the treatment pathway to TT including the time from diagnosis to initiation of TT and adherence. Methods: A retrospective cohort study was performed using anonymised patient-level data from UK, France, Germany, Italy, and Australia from 01/01/2005 to 01/05/2016. Patients were included if their first TT regimen was recorded during this period and they had ≥12 months data pre-index (COPD diagnosis). The proportion of patients on TT before COPD diagnosis was also determined. Treatment pathways and time to TT initiation following index were evaluated. Adherence to TT was estimated using proportion of days covered. Results: Overall 130,729 eligible patients were included. Mean age at diagnosis ranged from 63.4 (SD:10.4) years [pneumologist-treated in Germany] to 69.8 (9.9) years [Italy]. Time to TT ranged from median 16.9 months in Australia (IQR: 5.7 – 36.2) to 42.5 months in the UK (IQR: 13.9 -87.4). TT initiated first formed the largest treatment pathway (7.5% in UK to 17.1% in France). In meta-analyses of patients across all countries, 20.4% (95% CI: 13.8-29.1%) of patients initiated TT prior to COPD diagnosis. Estimated adherence was >80% in all countries during the time the patient was persistent with TT. Conclusions: Diverse patient pathways to TT were observed both between and within countries, many of which do not align with COPD treatment recommendations.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128975080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa703
F. Abdallah, I. Bachouch, N. Belloumi, S. Fenniche
{"title":"Correlation between COPD assessment test (CAT) and mMRC dyspnea scale in evaluationg COPD symptoms","authors":"F. Abdallah, I. Bachouch, N. Belloumi, S. Fenniche","doi":"10.1183/13993003.congress-2019.pa703","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa703","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131496768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa724
H. Souza, M. Pessoa, Rafaela Clemente, A. Silva, Erika Andrade, C. Reinaux, Luciana Alcoforado, Juliana Fernandes Barbosa, P. Moura, A. Andrade
{"title":"Efficacy of the association of inspiratory muscle training with whole body vibration on respiratory muscle strength, functionality, balance and physical performance in pre-frail older women: a randomized double-blind clinical trial","authors":"H. Souza, M. Pessoa, Rafaela Clemente, A. Silva, Erika Andrade, C. Reinaux, Luciana Alcoforado, Juliana Fernandes Barbosa, P. Moura, A. Andrade","doi":"10.1183/13993003.congress-2019.pa724","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa724","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131189171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa723
N. Launders, D. Ryan, C. Winchester, D. Skinner, Priyanka Raju Konduru, D. Price
{"title":"Management of community-acquired pneumonia in primary care: an observational study","authors":"N. Launders, D. Ryan, C. Winchester, D. Skinner, Priyanka Raju Konduru, D. Price","doi":"10.1183/13993003.congress-2019.pa723","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa723","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114370171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa715
S. Nair, P. Arjun
Introduction: Demonstration of post-bronchodilator reversibility is considered as an important tool for the diagnosis of Asthma, however this is not demonstrable in all patients. Aims and Objectives: To determine the proportion of patients with Asthma presenting to tertiary care hospital in Trivandrum, South India who show post-bronchodilator reversibility on spirometry and to determine the factors associated with reversibility Methods: Consecutive patients with clinician diagnosed asthma (by a senior pulmonologist, based on GINA guidelines) underwent spirometry as part of their diagnostic work-up at the time of their presentation in two tertiary care hospitals. Pre- and post bronchodilator spirometry were done by an expert technician. Reversibility was defined as increase in FEV1 by 200ml and 12% Results: 200 consecutive patients with Asthma were recruited. Mean age of the patients was 41.5 years (SD - 18.2). 59.5% of the patients were femaies. The proportion of patients with reversibility was 47% (95%CI-40%,54%). The factors associated with reversibility were low age( 0.05). Conclusion: While developing local guidelines for diagnosis of Asthma, the fact that reversibility can be demonstrated only less than 50% of patients must be considered, otherwise a significant proportion of cases with Asthma may be missed or misdiagnosed as COPD.
{"title":"Bronchodilator reversibility among patients with asthma presenting to tertiary care hospitals in Trivandrum, India","authors":"S. Nair, P. Arjun","doi":"10.1183/13993003.congress-2019.pa715","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa715","url":null,"abstract":"Introduction: Demonstration of post-bronchodilator reversibility is considered as an important tool for the diagnosis of Asthma, however this is not demonstrable in all patients. Aims and Objectives: To determine the proportion of patients with Asthma presenting to tertiary care hospital in Trivandrum, South India who show post-bronchodilator reversibility on spirometry and to determine the factors associated with reversibility Methods: Consecutive patients with clinician diagnosed asthma (by a senior pulmonologist, based on GINA guidelines) underwent spirometry as part of their diagnostic work-up at the time of their presentation in two tertiary care hospitals. Pre- and post bronchodilator spirometry were done by an expert technician. Reversibility was defined as increase in FEV1 by 200ml and 12% Results: 200 consecutive patients with Asthma were recruited. Mean age of the patients was 41.5 years (SD - 18.2). 59.5% of the patients were femaies. The proportion of patients with reversibility was 47% (95%CI-40%,54%). The factors associated with reversibility were low age( 0.05). Conclusion: While developing local guidelines for diagnosis of Asthma, the fact that reversibility can be demonstrated only less than 50% of patients must be considered, otherwise a significant proportion of cases with Asthma may be missed or misdiagnosed as COPD.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128445837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa732
Pin-Kuei Fu
{"title":"Health Care Expenses for COPD with Late Do-Not-Resuscitate (DNR) Decisions Escalate Nearly 2-Fold in Final Admission of Life","authors":"Pin-Kuei Fu","doi":"10.1183/13993003.congress-2019.pa732","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa732","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121595950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4001
C. Muñoz-Pindado, V. Arribas-Peña, E. Muñoz-Herrera, S. Sánchez-Belmonte, B. Mateu-Carralero, A. Darnés-Surroca, M. Callís-Privat, I. Casademunt-Codina, F. Ruiz-Mori, N. Roger-Casals
{"title":"Implementation of simplified method for SAHS diagnosis in primary care","authors":"C. Muñoz-Pindado, V. Arribas-Peña, E. Muñoz-Herrera, S. Sánchez-Belmonte, B. Mateu-Carralero, A. Darnés-Surroca, M. Callís-Privat, I. Casademunt-Codina, F. Ruiz-Mori, N. Roger-Casals","doi":"10.1183/13993003.congress-2019.pa4001","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4001","url":null,"abstract":"","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114269906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa5007
P. White, G. Gilworth, M. Thomas, C. Corrigan, Patrick J. Murphy, N. Hart, Leslie A. Hamilton, T. Harries
Background: High-dose inhaled corticosteroids (HD-ICS) are prescribed frequently outside guidelines in COPD, especially with mild or moderate airflow limitation. The acceptability and safety of withdrawal of HD-ICS in these patients is unknown. Aim: Feasibility study of a trial of the safe withdrawal of HD-ICS prescribed outside guidelines in COPD patients with mild or moderate airflow limitation. Method: COPD patients with mild or moderate airflow limitation using HD-ICS were invited to participate by their GPs. The challenges of identifying those suitable for inclusion have been described elsewhere. Participants were randomised to withdrawal from or continued use of HD-ICS. Impact of withdrawal was assessed through measures of lung function, quality of life, exacerbations, cellular and molecular biomarkers and neural respiratory drive. Measures were repeated at 3 and 6 months. Results: 61 patients attended. All agreed to undertake HD-ICS withdrawal. 21 patients were excluded due to: FEV1 reversibility (49%), severe airflow limitation (29%), no airflow obstruction (10%), frequent exacerbations in past year (4%), hospital admission for exacerbation (4%), BMI >35 (4%). 40 patients were recruited to the feasibility study. 20 were randomised to withdraw from HD-ICS use, 20 to continue HD-ICS use. Among the withdrawal arm, 5 resumed HD-ICS because of a decline in lung function or patient choice. Conclusions: A trial of the withdrawal of HD-ICS is feasible and acceptable to eligible patients responding to invitation. Of priority are identification of suitable patients and careful monitoring to detect a decline in lung function following withdrawal.
{"title":"Withdrawal of high-dose inhaled corticosteroids in COPD patients with mild or moderate airflow limitation: a feasibility study in primary care","authors":"P. White, G. Gilworth, M. Thomas, C. Corrigan, Patrick J. Murphy, N. Hart, Leslie A. Hamilton, T. Harries","doi":"10.1183/13993003.congress-2019.pa5007","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5007","url":null,"abstract":"Background: High-dose inhaled corticosteroids (HD-ICS) are prescribed frequently outside guidelines in COPD, especially with mild or moderate airflow limitation. The acceptability and safety of withdrawal of HD-ICS in these patients is unknown. Aim: Feasibility study of a trial of the safe withdrawal of HD-ICS prescribed outside guidelines in COPD patients with mild or moderate airflow limitation. Method: COPD patients with mild or moderate airflow limitation using HD-ICS were invited to participate by their GPs. The challenges of identifying those suitable for inclusion have been described elsewhere. Participants were randomised to withdrawal from or continued use of HD-ICS. Impact of withdrawal was assessed through measures of lung function, quality of life, exacerbations, cellular and molecular biomarkers and neural respiratory drive. Measures were repeated at 3 and 6 months. Results: 61 patients attended. All agreed to undertake HD-ICS withdrawal. 21 patients were excluded due to: FEV1 reversibility (49%), severe airflow limitation (29%), no airflow obstruction (10%), frequent exacerbations in past year (4%), hospital admission for exacerbation (4%), BMI >35 (4%). 40 patients were recruited to the feasibility study. 20 were randomised to withdraw from HD-ICS use, 20 to continue HD-ICS use. Among the withdrawal arm, 5 resumed HD-ICS because of a decline in lung function or patient choice. Conclusions: A trial of the withdrawal of HD-ICS is feasible and acceptable to eligible patients responding to invitation. Of priority are identification of suitable patients and careful monitoring to detect a decline in lung function following withdrawal.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122574193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：