Chronic Respiratory Disease最新文献

{"title":"Prescribing trends and environmental impact of prescribed inhaled medicines in Australia.","authors":"Sharon W L Lam, Vidya V Navaratnam, Danielle F Wurzel, Brett Montgomery, John D Blakey","doi":"10.1177/14799731261429092","DOIUrl":"10.1177/14799731261429092","url":null,"abstract":"<p><p>Pressurised metered dose inhalers (pMDIs) release greenhouse gases with substantially higher carbon dioxide equivalent (CO₂e) emission than other inhalers. Data from the Pharmaceutical Benefits Scheme (PBS) from 2013-2023, showed 28.3% increase in inhalers prescribed. pMDIs account for 47.5% of inhalers prescribed, contributing to 95.6 of inhaler-related carbon emissions. Targeted strategies to optimise disease control and promote use of non-pMDI inhalers where clinically appropriate can significantly reduce emissions while maintaining high-quality care.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261429092"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on medication literacy among patients with chronic obstructive pulmonary disease.","authors":"Zhu Jiahui, Li Jiaqi, Zhou Yue, Zhao Ruining, Guo Hao, Shi Xinqian, Shang Linping","doi":"10.1177/14799731261454688","DOIUrl":"10.1177/14799731261454688","url":null,"abstract":"<p><p>ObjectiveGuided by the medication literacy conceptual model, this study represents an interpretive exploration of medication literacy among patients with Chronic Obstructive Pulmonary Disease (COPD) to provide evidence for strategies aimed at improving medication adherence.MethodsUsing purposive sampling, 18 patients were recruited from the respiratory department and outpatient clinics of a tertiary general hospital in Shanxi Province between March and July 2025. Data were collected via semi-structured interviews and analyzed using directed content analysis method.ResultsThe analysis yielded four primary themes: functional, communicative, and critical medication literacy, as well as medication numeracy. These findings indicate that medication literacy in COPD patients is influenced by multidimensional factors, highlighting the complex challenges and subjective barriers in both cognitive and behavioral domains.ConclusionThese findings suggest that future interventions could prioritize patient-centered, personalized nursing interventions tailored to these specific literacy deficits-particularly in numeracy and critical processing-to effectively enhance treatment adherence and quality of life for COPD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261454688"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lived experiences of individuals with early stage non-small cell lung cancer following lung surgery: A rapid ethnographic approach.","authors":"Sarah Haesevoets, Anouk J L Muijsenberg, Dries Cops, Samantha L Harrison, Maarten Criel, David Ruttens, Marc Daenen, Martijn A Spruit, Heleen Demeyer, Chris Burtin","doi":"10.1177/14799731261438123","DOIUrl":"10.1177/14799731261438123","url":null,"abstract":"<p><p>BackgroundIndividuals with early-stage non-small cell lung cancer (NSCLC) often show reduced exercise capacity and physical activity (PA) after surgery, with or without (neo-)adjuvant therapy. However, understanding of peoples' lived-lives following lung cancer diagnosis and surgery remains unknown.ObjectiveThis study aimed to deeper understand how lung cancer diagnosis and surgery shape individuals' daily lives within one to three months post-surgery.MethodsAdults (18+) with stage I-IIIA NSCLC were recruited one to three months after surgery or (neo-)adjuvant therapy including radio-/chemo-/immunotherapy. A rapid ethnographic approach was used. Participants were observed at home during three two-hour visits, with a semi-structured interview during the last visit. Field notes and transcripts were thematically analyzed in Atlas.ti using a hybrid approach. Initial themes were deductively guided by the 14-domain TDF and inductively refined. Final themes were mapped onto the COM-B model.Results16 individuals (69% female; 69±7 years; 3820±2207 steps/day; 6±8 min/day moderate-to-vigorous PA; 44% received (neo-)adjuvant therapy) participated in home observations (86h total, range 4-6h) and a semi-structured interview during the last visit (383min total, range 16-44min). Four key themes were identified; 1) Physical consequences affecting daily life; 2) Emotional and social coping; 3) Motivation and barriers influencing PA and rehabilitation; 4) Gaps in education and guidance.ConclusionLung cancer surgery (with or without (neo-)adjuvant therapy) causes physical, emotional, and social challenges that impair daily life. PA and engagement to rehabilitation is often limited by symptoms and contextual barriers. Tailored rehabilitation addressing individuals' living conditions, physical, and emotional needs are considered crucial for recovery.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261438123"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal equipment, not minimal rehabilitation: Preserving quality as pulmonary rehabilitation evolves.","authors":"Hanoof A Aljohani, Thomas J C Ward","doi":"10.1177/14799731261499712","DOIUrl":"https://doi.org/10.1177/14799731261499712","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261499712"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics of people with COPD who enrol in home-based pulmonary rehabilitation versus centre-based pulmonary rehabilitation: A nationwide cross-sectional study.","authors":"Alexander Adamson, Harley Kwok, Sally J Singh, Tom M A Wilkinson, Holly Drover, Jennifer K Quint","doi":"10.1177/14799731261431253","DOIUrl":"10.1177/14799731261431253","url":null,"abstract":"<p><p>ObjectivesHome-based pulmonary rehabilitation (PR) is increasingly offered as an alternative to centre-based PR. This study explores differences in the characteristics of people with COPD enrolling in home-based versus centre-based PR in England and Wales and assesses whether availability of home-based PR is associated with increased enrolment.MethodsThis study used data from the UK 2023-24 National Respiratory Audit Programme PR audit. Eligible people had a primary condition of COPD, complete mental health and geographic data, and attended an initial assessment at a centre that completed the clinical and organisational audit. For the primary analysis only, people were further restricted to those enrolled on a purely home-based or centre-based programme at a centre that offered both options. Enrolment was defined as having attended an initial assessment and having at least one scheduled PR session with a defined start date. Differences in characteristics were assessed using Chi-square and Kruskal-Wallis tests. The association between availability of home-based PR and enrolment was assessed using a mixed-effects logistic regression model.Results13719/29981 (45.8%) people were eligible for inclusion in the primary analysis and 25039/29981 (83.5%) were eligible for the secondary analysis. Those who enrolled in a home-based programme were more likely to: be female (58.6% vs 48.2%; p<0.001); be more deprived (55.7% versus 46.6% in IMD quintiles 1 or 2, p<0.001); have a greater mental health burden (28.2% versus 22.2% with at least 1 cognitive impairment recorded, p<0.001); and classified their symptom burden as more severe at assessment (CAT score 23 versus 22, p <0.001). Home-based PR was unavailable for 9099/25039 (36.3%) people. Availability of home-based PR was not associated with reduced non-enrolment in PR when compared with centres that did not offer home-based PR (adj-OR for non-enrolment: 0.79; 95%CI:0.51-1.23)).ConclusionHealthcare providers and those developing home-based PR digital applications should consider tailoring their approach to those who are most likely to opt in, who tend to be younger, female, and have a higher burden of respiratory symptoms and mental health comorbidities.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261431253"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared decision-making about prolonged invasive ventilation for adults with myotonic dystrophy type 1.","authors":"Jalal Moolji, Erika MacIntyre, Maria Castro Codesal, Janice Richman-Eisenstat","doi":"10.1177/14799731261469849","DOIUrl":"10.1177/14799731261469849","url":null,"abstract":"<p><p>The option of tracheostomy and prolonged invasive mechanical ventilation (IMV) for chronic respiratory failure in myotonic dystrophy type 1 (DM1) poses challenges in decision-making. The Myotonic Dystrophy Foundation consensus recommendations on respiratory management do not directly address the implications of this intervention given the progressive physical and cognitive manifestations of DM1. Here, we consider IMV in DM1 using the ethical principles of beneficence, non-maleficence, autonomy and justice. We call for further research on post-tracheostomy morbidity, mortality, and quality of life (QOL) to help guide decision-making. Our ethical analysis has yielded programmatic changes we hope will improve patient outcomes.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261469849"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional and national trends in burden of chronic obstructive pulmonary disease from 2000 to 2021 and the prediction for 2030.","authors":"Jian Xu, Huiqing Xu, Dandan Zhang, Xiaojing Deng, Yeping Bian, Yunting Xu, Guofeng Ao, Jiannan Liu, Fei Xu","doi":"10.1177/14799731261432520","DOIUrl":"10.1177/14799731261432520","url":null,"abstract":"<p><p>AimsTo estimate the global burden of chronic obstructive pulmonary disease (COPD) by age, gender and socioeconomic status from 2000 to 2021, and make a prediction until 2030.MethodsData were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. The burden of COPD, referred to absolute numbers of COPD case and age-standardized rates (ASRs) per 100,000 individuals per year. The temporal trends from 2000 to 2021 were examined using Joinpoint models. Bayesian age-period-cohort models were introduced to project the burden until 2030. Finally, a decomposition analysis was conducted to reveal the contributions of aging, population growth and epidemiological changes to trends in COPD burden.ResultsThe crude numbers of incident cases, prevalent cases, deaths, and disability-adjusted life years (DALYs) for COPD remained increasing from 2000 to 2021, and until 2030, worldwide. ASRs of incidence, prevalence, deaths, and DALYs were in decreasing trends, and would continue to decline until 2030. Additionally, in 2021, the ASR of COPD burden was higher in males than females, while the age-specific rate increased with age. The disease burden varied across different regions, with a high burden in low development-level regions. The increasing burden of COPD was primarily driven by rapid aging and population growth.ConclusionsThe global ASRs of COPD burden would remain declining, but the crude burden would continue to increase until 2030. This study has public health implications for population-based interventions against COPD with consideration of residents' age, gender and residing area as well as economic status.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261432520"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and prehabilitation in lung transplant candidates: A cross-sectional UK survey of assessment, provision and barriers.","authors":"Laura McGarrigle, Gill Norman, Helen Hurst, Chris Todd","doi":"10.1177/14799731261441306","DOIUrl":"10.1177/14799731261441306","url":null,"abstract":"<p><p>ObjectivesFrailty is a multifactorial state of reduced physiological reserve and increased vulnerability, common in lung transplantation (LTx) candidates and associated with morbidity and mortality. There is no consensus on appropriate frailty instruments or optimal prehabilitation. Aims were to: (1) identify frailty measures in UK adult LTx candidates, (2) describe prescribed prehabilitation interventions, and (3) explore barriers to prehabilitation.MethodsAn anonymous online Qualtrics^XM survey was circulated via UK LTx coordinators and social media. Eligible respondents were professionals contributing to adult pre-operative assessment and listing decisions. Results were analysed using SPSS.ResultsThirty-one respondents met criteria, representing all five UK LTx centres. Frailty was always assessed by 58.1% and sometimes by 25.8%, though comprehensive measurement tools were rarely used. Functional tools included the Short Physical Performance Battery and sit-to-stand tests. Assessments occurred pre-listing and during waitlisting. Frailty was discussed at all listing meetings and influenced transplant suitability. Outpatient prehabilitation included face to face, telephone, and local referrals, targeting exercise, nutrition, and psychosocial needs. Reported barriers were travel, funding, and limited space.ConclusionUK lung transplant services conceptually recognise frailty as multidimensional and clinically important, but operationally rely on pragmatic, largely physical proxy measures. Prehabilitation provision is variable and often externally delivered constrained by system-level resource and access barriers.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261441306"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to indoor wood smoke, rather than hypoxemia, is a risk factor for cognitive impairment in COPD patients living at high altitude.","authors":"Mauricio González-García, Nadia Juliana Proaños, Alejandro Casas-Herrera, Abraham Alí-Munive, Carlos Eduardo Aguirre-Franco, Carlos Arturo Torres-Duque","doi":"10.1177/14799731261462164","DOIUrl":"10.1177/14799731261462164","url":null,"abstract":"<p><p>BackgroundIn the general population without COPD, indoor air pollution from biomass is a causal factor of cognitive impairment (CI). CI is also common in patients with tobacco smoke COPD and has been associated with hypoxemia and cardiovascular comorbidities. CI and its risk factors have not been evaluated in COPD patients living at high altitude, who experience greater hypoxemia and frequent exposure to wood smoke.MethodsPatients with COPD residing at high altitude with FEV1/FVC <0,70 and COPD risk factors (wood smoke, Tobacco smoke or combined exposure). Measurement of the Mini-Mental State Examination to assess CI, educational level, comorbidities, exacerbations, arterial blood gases, diffusion (DLCO), and 6-min walk test (6MWT). Comparisons between groups with and without CI using the X2 test and unpaired t-test. Logistic regression with odds ratio (OR) calculation was used to evaluate the association of CI with the variables of interest.ResultsIn the 199 patients included, 16.1% had CI, the majority with mild involvement (68.8%). Those with CI had more frequent exposure to wood smoke (p<0.001), older age (p=0.017), lower educational level, PaO2 (p=0.032), DLCO (p=0.036), and fewer meters in the 6MWT (p=0.007), with no differences in sex, severity of obstruction or comorbidities. Adjusting for the other variables, exposure to wood smoke was associated with CI [OR and 95% CI: 4.82 (1.62-14.33).ConclusionsIn patients with mild to moderate COPD living at high altitude, regardless of hypoxemia, age, educational level, comorbidities, and lung function, exposure to wood smoke was associated with CI.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261462164"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding exacerbation risk in BLVR: A logistic regression approach to complication prediction.","authors":"Johannes Wienker, Kaid Darwiche, Rüdiger Karpf-Wissel, Erik Büscher, Johannes Haubold, David Kersting, Hubertus Hautzel, Lukas van de Sand, Aymen Kassem, Kristin Mersmann, Christian Taube, Marcel Opitz, Marc Struß","doi":"10.1177/14799731261443319","DOIUrl":"10.1177/14799731261443319","url":null,"abstract":"<p><p>BackgroundChronic obstructive pulmonary disease (COPD) with emphysema is associated with persistent airflow limitation and frequent exacerbations. Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) improves lung function and quality of life but carries a risk of postprocedural complications, including acute exacerbations and pneumonia. Predictors of these adverse events remain incompletely defined.PurposeTo identify clinical and inflammatory factors associated with postprocedural exacerbations in patients undergoing BLVR with EBVs, aiming to support individualized risk stratification.Patients and MethodsWe retrospectively analyzed 320 patients with advanced emphysema treated with EBVs between 2015 and 2022. Patients underwent comprehensive preprocedural evaluation, including pulmonary function testing, imaging, perfusion scintigraphy, 6-minute walk test and COPD Assessment Test. Postprocedural exacerbations within 8 weeks were documented clinically and radiographically. Binary logistic regression, including multivariable modeling, was used to identify independent predictors.ResultsThirty-five patients (10.9%) developed post-BLVR exacerbations, six of whom had pneumonia. Exacerbation risk was independently associated with diabetes mellitus type II (OR 11.0, <i>p</i> < 0.001), elevated C-reactive protein >1 mg/dL (OR 9.35, <i>p</i> < 0.001), WBC >11 cells/nL (OR 5.46, <i>p</i> = 0.002), prior exacerbation frequency (OR 2.94, <i>p</i> < 0.001) and low BMI (OR 0.78, <i>p</i> < 0.001). Residual volume showed a trend toward significance (<i>p</i> = 0.058). The final model demonstrated excellent discriminative ability (AUC = 0.923). While lung function improvement was attenuated in the exacerbation group, quality of life gains were comparable.ConclusionElevated inflammatory markers, diabetes, frequent prior exacerbations and low BMI were independently associated with early postprocedural exacerbations following BLVR with EBVs. Comprehensive preprocedural assessment and targeted management of these risk factors may enhance patient safety and improve outcomes.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261443319"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}