特发性肺纤维化和其他间质性肺病的咳嗽负担:系统证据综述。

IF 5.8 2区 医学 Q1 Medicine Respiratory Research Pub Date : 2024-08-27 DOI:10.1186/s12931-024-02897-w
Rhiannon Green, Michael Baldwin, Nick Pooley, Kate Misso, Maureen Pmh Rutten-van Mölken, Nina Patel, Marlies S Wijsenbeek
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引用次数: 0

摘要

背景:咳嗽仍然是特发性肺纤维化(IPF)和其他间质性肺疾病(ILDs)患者的一个顽固症状。为了给未来的研究、治疗和护理模式提供信息,我们首次对咳嗽相关负担的证据进行了系统综合:我们使用 Embase、MEDLINE 和 Cochrane Library 等数据库对 2010 年 1 月至 2023 年 10 月间发表的文章进行了文献检索。IPF和其他ILD患者中报告咳嗽相关措施的研究符合纳入条件。纳入的研究根据其研究的 ILD 类型和设计进行分类。提取了研究细节、患者特征和结果,并评估了偏倚风险。采用叙事综合法解释研究结果:结果:共纳入 61 项研究:结果:共纳入 61 项研究:33 项针对 IPF,18 项针对混合型ILD,6 项针对结缔组织病相关型ILD,4 项针对肉样瘤病。这些研究使用了一系列工具来评估咳嗽及其影响。最常用的咳嗽测量方法是咳嗽严重程度视觉模拟量表(VAS)和客观咳嗽次数,而最常用的健康相关生活质量(HRQoL)/影响测量方法是圣乔治呼吸问卷(SGRQ)和莱斯特咳嗽问卷(LCQ)。在 IPF 中,不断有研究报告称各种咳嗽与 HRQoL 测量之间存在相关性,包括咳嗽 VAS 评分与客观咳嗽次数、LCQ 评分与 SGRQ 评分之间的相关性。在其他 ILD 的研究中也观察到了类似的相关性,但数据较为有限。针对 IPF 和其他 ILD 的定性研究一致强调了患者承受的与咳嗽相关的巨大负担,包括日常活动受阻、疲劳和社交尴尬。虽然没有专门调查咳嗽经济负担的研究,但一项针对纤维化 ILD 患者的研究发现,咳嗽严重程度与工作场所生产力损失有关:我们的研究强调了评估咳嗽及其对 IPF 和其他 ILD 影响的异质性。研究结果证实了咳嗽对 IPF 患者 HRQoL 的负面影响,并表明咳嗽对其他 ILD 也有类似影响。我们的综述强调了标准化评估工具和专门研究的必要性,尤其是在非 IPF ILD 和咳嗽的经济负担方面。
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The burden of cough in idiopathic pulmonary fibrosis and other interstitial lung diseases: a systematic evidence synthesis.

Background: Cough remains a persistent symptom in patients with idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs). To inform future research, treatment and care models, we conducted the first systematic synthesis of evidence on its associated burden.

Methods: A literature search was performed for articles published between January 2010 and October 2023 using databases including Embase, MEDLINE and the Cochrane Library. Studies in patients with IPF and other ILDs reporting cough-related measures were eligible for inclusion. Included studies were categorised based on the types of ILD they examined and their design. Study details, patient characteristics and outcomes were extracted, and the risk of bias was assessed. A narrative synthesis approach was employed to interpret the findings.

Results: Sixty-one studies were included: 33 in IPF, 18 in mixed-ILDs, six in connective tissue disease-associated-ILDs and four in sarcoidosis. Across the studies, a range of tools to assess cough and its impact were used. The most frequently used measures of cough were cough severity visual analogue scale (VAS) and objective cough counts, whereas the most frequently used health-related quality of life (HRQoL)/impact measures were the St. George's Respiratory Questionnaire (SGRQ) and Leicester Cough Questionnaire (LCQ). In IPF, studies consistently reported correlations between various cough and HRQoL measures, including between cough VAS scores and objective cough counts, LCQ scores and SGRQ scores. Similar correlations were observed in studies in other ILDs, but data were more limited. Qualitative studies in both IPF and other ILDs consistently highlighted the significant cough-related burden experienced by patients, including disruption of daily activities, fatigue and social embarrassment. Although there were no studies specifically investigating the economic burden of cough, one study in patients with fibrotic ILD found cough severity was associated with workplace productivity loss.

Conclusions: Our study underscores the heterogeneity in assessing cough and its impact in IPF and other ILDs. The findings confirm the negative impact of cough on HRQoL in IPF and suggest a comparable impact in other ILDs. Our synthesis highlights the need for standardised assessment tools, along with dedicated studies, particularly in non-IPF ILDs and on the economic burden of cough.

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来源期刊
Respiratory Research
Respiratory Research RESPIRATORY SYSTEM-
CiteScore
9.70
自引率
1.70%
发文量
314
审稿时长
4-8 weeks
期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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