Chronic Respiratory Disease最新文献

{"title":"Effect of individual nutritional therapy during inpatient pulmonary rehabilitation in patients at risk for malnutrition and sarcopenia - a randomized controlled trial.","authors":"Marco Coiro, Andrea Zurfluh, Undine Lehmann, Patrick Brun, Anke Scheel-Sailer, Hansueli Tschanz, Ann van Hoof, Matthias Wilhelm, Thimo Marcin","doi":"10.1177/14799731251350692","DOIUrl":"10.1177/14799731251350692","url":null,"abstract":"<p><p>BackgroundMalnutrition and sarcopenia are common in inpatient rehabilitation, however individual nutritional therapy (iNT) is often underutilized. This study aimed to assess the effect of iNT on nutrition and muscular health.MethodPatients with chronic obstructive pulmonary disease (COPD) or post-pneumonia at risk for malnutrition and sarcopenia undergoing inpatient rehabilitation were enrolled. The control group received usual care including enriched food and educational group sessions on nutrition. The intervention group received additional counselling by a dietician twice a week. Both groups received individualized physiotherapy and self-management coaching, endurance exercise sessions on 5 days and strength training sessions on 2-3 days per week as part of the clinical routine. Primary outcomes were changes in energy and protein intake, assessed via menu consumption and macronutrient analysis. Secondary outcomes included handgrip strength, muscle mass by bioimpedance analysis, and physical performance measured by the timed-up-and-go test.ResultsTwenty-six patients per group (median age of 72 years, 60% men, 52% COPD) were included. Energy and protein intake increased significantly more in the intervention group with a 309 kcal and 16 g compared to -53 kcal and -1 g in the control group (<i>p</i> = 0.001 for group differences). Handgrip improved more in the intervention group by a median of 1 kg (<i>p</i> = 0.007), without group differences in muscle mass or physical performance.ConclusionINT effectively increased energy and protein intake in patients at risk of malnutrition and sarcopenia undergoing 3 weeks of pulmonary rehabilitation, with a positive impact on prognostic handgrip strength.Trial registrationThe study was registered by the US National Institutes of Health (ClinicalTrials.gov). # NCT05096013.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251350692"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301218","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":"Assessment and management of frailty during pulmonary rehabilitation: An international survey of Australian and New Zealand clinicians.","authors":"A L Alzubaidi, S Soh, M Wuyts, P Munro, K D Hill, C R Osadnik","doi":"10.1177/14799731251400252","DOIUrl":"10.1177/14799731251400252","url":null,"abstract":"<p><p>BackgroundFrailty is common among patients referred to pulmonary rehabilitation (PR) programs. While it is considered an independent predictor of program non-completion, people with frailty respond positively to PR. Clinicians' perspectives on assessing and managing frailty in PR has not been established. This study aimed to identify clinicians' current practices, perceptions, and opinions on assessing and managing frailty in people who attend PR in Australia and New Zealand.MethodsAn international online survey targeting healthcare professionals in Australia and New Zealand involved in PR programs using a combination of multiple-response closed-ended and open-ended questions. This survey study was reported in accordance with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).ResultsOf 103 responses, 89 healthcare professionals completed the survey (92.6% completion rate). Nineteen percent routinely assessed frailty, mostly using Short Physical Performance Battery (SPPB). Respondents reported the main considerations for choice of frailty assessment tools were ease of use and cost. The most common frailty indicators identified by respondents included falls history, low body weight, slow or aided gait, and muscle weakness. Seventy-nine percent believed PR to be appropriate to manage frailty in this population, while 94% desired additional resources in future guidelines. Suggestions to improve PR to better manage frailty included reshaping rehabilitation program content, and providing specific patient education. Future desired research priorities included improvements to frailty assessment tools, frailty-specific guidelines and workforce training.ConclusionThis study explores PR practices among clinicians in Australia and New Zealand, showing variability in frailty assessment and management. It provides a foundation for evaluating key aspects of PR models that can be tailored to these clients' needs and limitations.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251400252"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523027","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":"Association between skeletal muscle index and lung function in populations with different characteristics.","authors":"Xian-Xin Xia, Xin-Xin Xue, Li Xiong, Ya-Jun Chen, Hao Chen, Fang He, Qi Li","doi":"10.1177/14799731251406900","DOIUrl":"10.1177/14799731251406900","url":null,"abstract":"<p><p>IntroductionCurrent research mainly examines the link between sarcopenia and obstructive spirometry, with limited studies on preserved ratio impaired lung function (PRISm). This study aims to investigate the association between skeletal muscle index (SMI) and lung function indicators in populations with different characteristics, with particular emphasis on the PRISm population.MethodsData were utilized from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 cycle. The participants were categorized into three groups: obstructive spirometry, PRISm, and normal spirometry. The SMI was calculated by dividing appendicular skeletal muscle mass by body mass index. Multiple linear regression analysis was employed to explore the relationship between the SMI and lung function indicators, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC).ResultsAmong the 2513 participants aged 20-59 years, 2096 had normal spirometry, 186 were in the obstructive spirometry group, and 231 were in the PRISm group. The SMI was significantly associated with lung function indicators after adujustment: in the obstructive spirometry group, per 0.1 unit increase in SMI was linked to an increase in FEV1 of 0.214 L (95% CI: 0.115-0.313, <i>p</i> < 0.001) and in FVC of 0.339 L (95% CI: 0.213-0.465, <i>p</i> < 0.001); in the PRISm group, per 0.1 unit increase in SMI was associated with an increase in FEV1 of 0.184 L (95% CI: 0.149-0.219, <i>p</i> < 0.001) and in FVC of 0.222 L (95% CI: 0.169-0.274, <i>p</i> < 0.001); and in the normal spirometry group, per 0.1 unit increase in SMI was linked to an increase in FEV1 of 0.240 L (95% CI: 0.222-0.257, <i>p</i> < 0.001) and in FVC of 0.316 L (95% CI: 0.294-0.338, <i>p</i> < 0.001).ConclusionOur study newly identifies a significant positive association between SMI and lung function in the PRISm group, a relationship also consistently observed in obstructive and normal spirometry groups.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251406900"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653827","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":"Clinical implications of frailty in hospitalized patients with pulmonary arterial hypertension.","authors":"Ashira Lokhandwala, Ali Salman Al-Timimi, Tania Da Silva, Sahar Nourouzpour, H S Jeffrey Man, Marc de Perrot, Kirsten Wentlandt, Nadia Sharif, Lianne G Singer, John Granton, Dmitry Rozenberg","doi":"10.1177/14799731251408844","DOIUrl":"10.1177/14799731251408844","url":null,"abstract":"<p><p>ObjectivesFrailty is associated with increased morbidity and mortality in chronic lung disease, but its prognosis has not been evaluated in pulmonary arterial hypertension (PAH). This study aimed to assess: (1) impact of frailty on hospital length of stay (LOS) and health-care utilization in PAH; (2) association of frailty with 1-year post-discharge outcomes.MethodsRetrospective, single-centered cohort study of consecutive PAH patients admitted non-electively (January 2009-December 2018), predominantly for right heart failure (57%). Frailty was defined as ≥ 0.25 using a cumulative deficits frailty index. Disease characteristics, hospital factors, and mortality were compared using univariate analysis and multivariable regression, adjusting for age and sex.Results44/96 (46%) PAH patients were frail. Frailty was associated with older age, greater comorbidities, and lower six-minute walk distance pre-admission (<i>p</i> < 0.05). Frail patients had a longer hospital LOS (4 days 95% (0.4-6.3), <i>p</i> = 0.04) and were more likely to receive social work consultation (36% vs 13%, <i>p</i> = 0.01), independent of age and sex. There were no adjusted differences (frail vs non-frail) in hospital mortality (OR:1.01 95% (0.28-3.72) or 12-months mortality post-discharge (HR:1.26 95% (0.48-3.29).ConclusionFrailty was associated with greater hospital LOS and interdisciplinary support, but not 1-year mortality. Future studies should explore whether alternative frailty models may be more informative of longer-term PAH outcomes.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251408844"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818480","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":"Use of implementation science to qualitatively identify implementation determinants of COPD practice guidelines in primary care.","authors":"Deepa Raghavan, Karen L Drummond, Sonya A Sanders, JoAnn Kirchner","doi":"10.1177/14799731251314870","DOIUrl":"10.1177/14799731251314870","url":null,"abstract":"<p><p><b>Objectives:</b> Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease with high morbidity and mortality. COPD guidelines (CPG) are greatly underutilized and studies attempting to improve this practice gap have yielded inconsistent results. We hypothesize that using implementation science can provide a detailed understanding of these practice gaps and the reasons behind them. <b>Methods:</b> Since primary care (PC) manages the bulk of COPD patients, in this pilot study, we use principles of implementation science to systematically explore the reasons for this implementation gap in a PC setting. We used the Consolidated Framework of Implementation Science (CFIR), a determinant framework to design semi-structured interview guides to conduct multistakeholder interviews to explore the barriers and facilitators to four key COPD-CPG with known poor uptake: inhaler education, spirometry, pulmonary rehabilitation and COPD-specific patient education from patient and provider perspectives. Qualitative analysis was performed using rapid analysis. <b>Results:</b> Seventeen respondents including both, patients and providers were interviewed. All these COPD-CPG were rated as 'highly important' suggesting that perceived importance alone is insufficient to bridge gaps in uptake. Respondents were least familiar with pulmonary rehabilitation. Physician time constraint was a significant reported barrier. There exist multilevel contextual barriers to each of these COPD-CPG. <b>Discussion:</b> To increase uptake of COPD guidelines, implementation efforts that address multilevel barriers and promote collaborative care by use of non-physician resources are likely to have higher buy-in and greater chances for success.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251314870"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254971","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":"Cut-offs for daily step counts are associated with measures of health status in people with COPD: An observational study.","authors":"Juliana M B Dos Santos, Fabiano F de Lima, Caroline M Censo, Eloise A Santos, Juliana T Ito, Rafaella F Xavier, Regina M Carvalho-Pinto, Celso R F Carvalho","doi":"10.1177/14799731251345490","DOIUrl":"10.1177/14799731251345490","url":null,"abstract":"<p><p><b>Objective:</b> To explore the associations between preestablished daily step count cut-offs and health status, dyspnoea, and psychosocial distress in individuals with COPD. <b>Methods:</b> A cross-sectional analysis was performed on 252 individuals with COPD. PADL was objectively assessed using a triaxial accelerometer, and participants were categorized as physically active or inactive according to three daily step count cut-offs previously reported for individuals with COPD (4,300, 4,580, and 5000 steps/day). Health status was measured via the COPD Assessment Test (CAT) and Clinical COPD Questionnaire (CCQ), dyspnoea was assessed via the modified Medical Research Council (mMRC) scale, and psychosocial distress was evaluated via the Hospital Anxiety and Depression Scale (HADS). <b>Results:</b> Meeting the cut-off of 5000 steps/day was associated with lower CAT scores and depressive symptoms. Meeting the cut-off of 4300 steps/day was associated with less dyspnoea (mMRC < 2). No significant associations were observed between anxiety symptoms and step count cut-offs. The 4580 steps/day cut-off did not predict health outcomes. <b>Conclusions:</b> A daily step count of 5000 steps appears to be the most effective threshold for distinguishing between different levels of health status and depressive symptoms in individuals with COPD. These findings suggest that step counts can be used as a clinical health indicator in this population. Future interventional studies are needed to confirm our findings.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251345490"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149252","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 prevalence of metabolic syndrome in chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Hassan Alrabbaie, Mohammad Al-Wardat, Mohammad Etoom, Marla Beauchamp, Roger Goldstein, Dina Brooks","doi":"10.1177/14799731251346194","DOIUrl":"10.1177/14799731251346194","url":null,"abstract":"<p><p>ObjectiveMetabolic syndrome (MetS) is a cluster of factors that increase the risk of cardiovascular disease and type 2 diabetes. It is highly prevalent among patients with Chronic Obstructive Pulmonary Disease (COPD). This systematic review and meta-analysis assessed MetS prevalence in COPD patients, focusing on variations by gender, diagnostic criteria, and disease severity.MethodsWe systematically searched MEDLINE, Embase, Scopus, and CINAHL. Two reviewers independently extracted data using a standardized form, and study quality was assessed with the Joanna Briggs Institute checklist. Prevalence rates, with 95% confidence intervals (CI), were calculated using a random-effects model. Subgroup analyses by sex, COPD severity, and MetS components were conducted.ResultsForty-two studies, including 54,278 COPD patients, were analyzed. Overall, the prevalence of MetS was 37% (95% CI: 30.6-43.8%; I² = 99.03%, p < 0.001). Prevalence was 48% (95% CI 38.1 to 57.5) in males and 43% (95% CI 38.3 to 48.8) in females. Among studies using the Alberti definition, the pooled prevalence was 46% (95% CI 35.6 to 56.3). Patients with GOLD stage II showed a prevalence of 44% (95% CI 37.3 to 50.4). The most common MetS components were Hypertension 58% (95% CI 47.2 to 68.0) and increased waist circumference 51% (95% CI 37.1 to 64.6).ConclusionMetS is highly prevalent among COPD patients. Standardized diagnostic criteria are needed, and early detection with integrated care is recommended.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251346194"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141865","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":"Longer daily oxygen use associates with more adverse events, symptoms, and worse health status in long-term oxygen therapy.","authors":"Filip Björklund, Magnus Ekström","doi":"10.1177/14799731251366962","DOIUrl":"10.1177/14799731251366962","url":null,"abstract":"<p><p>IntroductionUse of long-term oxygen therapy (LTOT) for more than 15 h per day does not reduce mortality or hospitalizations, but may increase the risk of adverse events. We evaluated the relationship between daily oxygen use duration and adverse events, symptoms, and health status in patients on LTOT.MethodsThis was a cross-sectional survey study of a random sample (<i>N</i> = 650) of adults with ongoing LTOT in Sweden. Oxygen use (h/day) was reported, and associations were analyzed with adverse events, symptom severities (revised Edmonton Symptom Assessment System), sleep duration and quality, and health status (COPD assessment test [CAT]).ResultsIn total, surveys from 204 patients were analyzed; 60% female, mean age 75.3 (SD 8.7) years. Swedevox baseline characteristics were similar between sampled respondents and non-respondents. Patients reporting 24 h of daily oxygen use (53.4%) also reported a higher number of total adverse events, higher ratings of dyspnea, depression and anxiety, and worse health status, compared to those reporting fewer hours of oxygen use. A longer daily duration of oxygen use also associated with a higher number of experienced adverse events, higher ratings of dyspnea and anxiety, and worse rated health status in crude and adjusted linear regression models. No associations were seen between oxygen use duration and sleep quality or duration.ConclusionMore adverse events, a higher severity of some symptoms, and worse health status are seen among patients with a longer daily duration of oxygen use. Further research is needed to establish evidence of causality.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251366962"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798330","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":"Telomere biology disorder associated lung disease- case report of a <i>TERT</i> gene variant as the cause of pleuroparenchymal fibroelastosis.","authors":"Julian Pott, Ann-Sophie Höing, Alexander Volk, Lennart Well, Fabian Beier, Dirk Lebrecht, Lars Harbaum, Hans Klose, Tim Oqueka","doi":"10.1177/14799731251370357","DOIUrl":"10.1177/14799731251370357","url":null,"abstract":"<p><p>Case presentationDescription of a patient with a progressive destructive lung disease resembling pleuroparenchymal fibroelastosis, liver cirrhosis and bone marrow changes. Genetic workup identified a rare heterozygous coding variant in the <i>TERT</i> (telomerase reverse transcriptase) gene c.472 C>T; p.(Leu158Phe) and telomere length testing revealed significant telomere shortening, supporting the diagnosis of telomere biology disorder (TBD).DiscussionTBD is an underrecognized cause of interstitial lung disease (ILD). It is a heterogeneous disease that can affect different organs, including lungs, liver and bone marrow. Genetic testing in ILD is crucial for early diagnosis, risk assessment, and family screening. Identifying this variant enables targeted genetic testing for relatives, allowing preventive measures and lifestyle modifications.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251370357"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029070","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":"Differences in COPD management across clinician type: Maintenance treatment habits and patient characteristics among US pulmonologists, internal/family medicine physicians, nurse practitioners, and physician assistants.","authors":"Mario Castro, Kevin C Carney, Steven M Romanelli, Amy L Dixon, Maryam Q Abdul Rahman, Kavita Aggarwal, Barbara P Yawn","doi":"10.1177/14799731251346191","DOIUrl":"10.1177/14799731251346191","url":null,"abstract":"<p><p>ObjectivesTreatment recommendations for chronic obstructive pulmonary disease (COPD) are based on single or combination long-acting bronchodilator therapy (β₂-agonists [LABAs] or muscarinic receptor antagonists [LAMAs]), with inhaled corticosteroids (ICS) for those at risk of exacerbations. This study evaluated differences in patient characteristics and treatment patterns among US clinicians.MethodsMedical record data for patients with COPD were abstracted via a retrospective cross-sectional survey by pulmonologists, internal/family medicine physicians, nurse practitioners (NPs) and physician assistants (PAs).ResultsData on 700 patients were collected from 175 clinicians: 100 pulmonologists, 45 internal/family medicine physicians, 30 NP/PAs. Respondents classified patients as having Mild (11%), Moderate (51%), or Severe/Very Severe (38%) COPD, with highest perceived disease burden for patients with Severe/Very Severe COPD. Dual therapies were prescribed differently according to clinician type. Internal/family medicine physicians and NP/PAs prescribed LABA/ICS to a significantly higher proportion of patients than pulmonologists, who favored use of dual bronchodilator therapy. Regardless of clinician type, COPD management was complex, with patients starting and transitioning to multiple treatments throughout their care.ConclusionDifferences in COPD treatment patterns exist across US clinicians. Despite current maintenance treatment, COPD had a profound impact on patients, indicating a need for improved therapies for COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251346191"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233368","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}