European Clinical Respiratory Journal最新文献

{"title":"An RCT of acute health effects in COPD-patients after passive vape exposure from e-cigarettes.","authors":"Karin Rosenkilde Laursen, Jakob Hjort Bønløkke, Elisabeth Bendstrup, Merete Bilde, Marianne Glasius, Vibeke Heitmann Gutzke, Shamjad Puthukkadan Moosakutty, Anna-Carin Olin, Peter Ravn, Kirsten Østergaard, Torben Sigsgaard","doi":"10.1080/20018525.2020.1861580","DOIUrl":"10.1080/20018525.2020.1861580","url":null,"abstract":"<p><p><b>Background</b>: E-cigarette use has been shown to have short-term acute effects among active users but less is known of the acute passive effects, particularly among individuals with existing respiratory diseases. <b>Objective</b>: To investigate local and systemic effects of short-term passive vape exposure among patients with mild or moderate chronic obstructive pulmonary disease (COPD). <b>Methods</b>: In a double-blinded crossover study 16 non-smoking COPD-patients (mean age 68) were randomly exposed for 4 h to passive vape (median PM_2.5: 18 µg/m³ (range: 8-333)) and clean air (PM_2.5 < 6 µg/m³) separated by 14 days. Particles were measured using an ultrafine particle counter (P-TRAK) and a scanning mobility particle sizer (SMPS). Health effects including Surfactant Protein-A (SP-A) and albumin in exhaled air, spirometry, FeNO, and plasma proteins were evaluated before, right after, and 24 hours after exposure. Participants reported symptoms throughout exposure sessions. Data were analyzed using mixed models. <b>Results</b>: SP-A in exhaled air was negatively affected by exposure to vape and several plasma proteins increased significantly. Throat irritation was more pronounced during passive vape exposure, while FVC and FEV₁ decreased, however, not significantly. <b>Conclusions:</b> SP-A in exhaled air and some plasma proteins were affected by passive vape in patients with COPD indicating inflammation, showing that passive vape exposure is potentially harmful.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1861580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38827814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity among Danish lung cancer patients before and after initial cancer diagnosis.","authors":"Anja Gouliaev, Ole Hilberg, Niels Lyhne Christensen, Torben Rasmussen, Rikke Ibsen, Anders Løkke","doi":"10.1080/20018525.2020.1861579","DOIUrl":"10.1080/20018525.2020.1861579","url":null,"abstract":"<p><p><b>Objective:</b> Lung cancer is the leading cause of cancer-related death worldwide. This population-based longitudinal study investigates survival rates and the burden of comorbidity before and after being diagnosed with lung cancer in Denmark. <b>Methods:</b> From the Danish National Patient Registry (NPR) and the Danish Civil Registration System (CPR), 53,749 patients with lung cancer were identified and matched with 214,304 controls on age, gender, region of residence and marital status in the period 1998-2010. From the NPR, data on survival and comorbidity, registered as ICD-10 diagnoses, were extracted. Comorbidity was assessed using the Deyo-Charlson comorbidity score (DCcs) and mortality using Kaplan-Meier survival curves. <b>Results:</b> 1-year survival rate for Danish lung cancer patients was 51.7 % (CI 51.3-52.1) and 5-year survival rate was 14.7 % (CI 14.3-15.0) compared to 96.8 % (CI 96.7-96.8) and 84.0 % (CI 83.9-84.2) for controls respectively. Overall, cases had significantly more comorbidity compared to controls before being diagnosed with lung cancer. Prior to being diagnosed with lung cancer, more cases than controls had been diagnosed with other malignancies (11.4 % vs 6.0 % p<0.005), diseases of the circulatory system (16.4 % vs 13.0 % p<0.005) and respiratory diseases (12.2 % vs 4.8 % p<0.005). Among lung cancer patients 21.8 % had a DCcs ≥ 1 compared to 13.3 % among controls (P<0.005). The 1-year survival for DCcs =0 was 54.8 % (CI 54.3-55.3) for lung cancer patients and 97.8 % (CI 97.7-97.9) for controls. Decreasing survival with increasing DCcs was found in both groups. <b>Conclusion:</b> This study provides unique nationwide comorbidity data on patients before and after being diagnosed with lung cancer. We found increased mortality with increasing comorbidity, however more pronounced among controls compared to patients with lung cancer.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/1a/ZECR_8_1861579.PMC7758043.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on living with severe asthma in Denmark and Sweden.","authors":"Georgia Papapostolou,&nbsp;Alf Tunsäter,&nbsp;Jonas Binnmyr,&nbsp;Gunilla Telg,&nbsp;Klaus Roslind","doi":"10.1080/20018525.2020.1856024","DOIUrl":"https://doi.org/10.1080/20018525.2020.1856024","url":null,"abstract":"<p><p><b>Background</b>: Severe asthma has an acknowledged impact on health-related quality of life (HRQOL) and is associated with substantial health care costs. This study aimed to investigate the patients' own experiences of the disease, perceptions of HRQOL, and awareness of disease management. <b>Methods</b>: This study included severe asthma patients in Sweden and Denmark. A quantitative Web-based survey and qualitative in-depth interviews (IDIs) were conducted. The survey included St. George's Respiratory Questionnaire (SGRQ), Asthma Control Test (ACT), Work Productivity and Activity Impairment (WPAI), and a study-specific questionnaire on quality of care and disease awareness. Telephone-based IDIs were conducted by medical interviewers following a semi-structured interview guide. <b>Results</b>: A total of 93 patients participated in the Web survey, and 33 participated in the IDIs. In the survey, the vast majority (77%; 72/93) had uncontrolled asthma (ACT<20). Mean total SGRQ score was 47.4 (59.7 symptom, 53.7 activity, 39.9 impact scores). Nearly 60% were treated in primary care. The IDIs revealed a long path to diagnosis, substantial and constant need for adaptations because of disease limitations, high burden on family members, social restrictions, and sick leaves and income losses. Patient awareness about guidelines, treatment goals, and available therapies was poor, and a low level of satisfaction by primary health care was seen. <b>Conclusions</b>: The vast majority of this severe asthma population had uncontrolled asthma and poor access to lung expert physicians. Impaired HRQOL despite patients' adaptations was indicated. These findings highlight the need for structured patient education and greater access to units with disease-specific knowledge.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1856024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39143030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspnea has an association with lifestyle: differences between Swedish and Finnish speaking persons in Western Finland.","authors":"Heidi Andersén,&nbsp;Pinja Ilmarinen,&nbsp;Jasmin Honkamäki,&nbsp;Leena E Tuomisto,&nbsp;Päivi Piirilä,&nbsp;Hanna Hisinger-Mölkänen,&nbsp;Anssi Sovijärvi,&nbsp;Helena Backman,&nbsp;Bo Lundbäck,&nbsp;Eva Rönmark,&nbsp;Lauri Lehtimäki,&nbsp;Hannu Kankaanranta","doi":"10.1080/20018525.2020.1855702","DOIUrl":"https://doi.org/10.1080/20018525.2020.1855702","url":null,"abstract":"<p><p><b>Background</b> Difference in dyspnea mMRC ≥2 between Finnish speaking and Swedish-speaking populations in Finland has not been previously studied. <b>Methods</b> In February 2016, a respiratory questionnaire was sent to 8000 randomly selected subjects aged 20-69 years in western Finland with a response rate of 52.3%. The registered native language of each subject determined whether questionnaire in Finnish or Swedish was applied. Multiple logistic regression was performed to calculate Odds Ratios (OR) with 95% CI for the simultaneous effects of independent variables on dyspnea mMRC ≥2. <b>Results</b> Of all participants, 2780 (71.9%) were Finnish speakers and 1084 (28.1%) were Swedish speakers. Finnish speakers had a higher prevalence of dyspnea mMRC ≥2 (11.1% vs 6.5% p < 0.001) when compared to Swedish speakers. Finnish speakers smoked more often, had higher BMI, spent less time moving during the day, had more often occupational exposure to vapours, gases, dusts or fumes (VGDF), and had lower socioeconomic status based on occupation. Significant risk factors for dyspnea mMRC ≥2 were COPD (OR = 10.94), BMI >35 (OR = 9.74), asthma (OR = 4.78), female gender (OR = 2.38), older age (OR = 2.20), current smoking (OR = 1.59), and occupational exposure to VGDF (OR = 1.47). <b>Conclusions</b> Swedish speakers had less dyspnea mMRC ≥2 which is explained by a healthier lifestyle. Smoking, obesity, and occupational exposures should be in focus to improve respiratory health.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1855702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38393602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue in idiopathic pulmonary fibrosis measured by the Fatigue Assessment Scale during antifibrotic treatment.","authors":"Line Kølner-Augustson,&nbsp;Thomas Skovhus Prior,&nbsp;Vibeke Skivild,&nbsp;Anette Aalestrup,&nbsp;Elisabeth Bendstrup","doi":"10.1080/20018525.2020.1853658","DOIUrl":"https://doi.org/10.1080/20018525.2020.1853658","url":null,"abstract":"<p><p><b>Background</b>: Fatigue is a common complaint in patients with idiopathic pulmonary fibrosis (IPF) and has been reported in a considerable percentage of patients. Fatigue is also a registered side effect of pirfenidone, one of two approved antifibrotic drugs. The Fatigue Assessment Scale (FAS) was developed for assessment of fatigue in sarcoidosis and validated in patients with sarcoidosis. FAS has been used in a few IPF studies but has not been validated. <b>Aims</b>: To study the change in FAS after initiation of pirfenidone or nintedanib in the treatment of patients with IPF during a six-month period. <b>Methods</b>: Between April 2017 and January 2018, all incident patients with IPF starting antifibrotic treatment were invited to complete FAS before, four weeks, three, and six months after initiation of antifibrotic treatment. Baseline characteristics including lung function were registered. <b>Results</b>: Fifty-two patients were included, mean FVC% 84.8, mean DLCO% 51.4. Nintedanib was started in 25 patients; 27 patients started pirfenidone. Sixty-four percent of patients had a FAS score >22 indicating substantial fatigue at baseline. There was no statistically significant difference in FAS score for patients treated with nintedanib or pirfenidone at any time point. FAS score increased statistically significantly during the six-month follow-up. This change was driven by patients without substantial fatigue at baseline with an increase in FAS score of 8.4 points; patients with substantial fatigue at baseline experienced no statistically significant change. <b>Conclusion</b>: A majority of patients with IPF suffered from substantial fatigue at the time of diagnosis. Fatigue progressed over time and increasing fatigue was associated with younger age, nintedanib treatment and low degree of fatigue at baseline. There was no significant difference in FAS score between the two antifibrotic treatments at any time point, even though fatigue is not a registered side effect in nintedanib.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1853658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38704803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and end-of-life aspects among subjects on long-term noninvasive ventilation.","authors":"Heidi A Rantala,&nbsp;Sirpa Leivo-Korpela,&nbsp;Siiri Kettunen,&nbsp;Juho T Lehto,&nbsp;Lauri Lehtimäki","doi":"10.1080/20018525.2020.1840494","DOIUrl":"https://doi.org/10.1080/20018525.2020.1840494","url":null,"abstract":"<p><strong>Background: </strong>The need for noninvasive ventilation (NIV) is commonly considered a predictor of poor survival, but life expectancy may vary depending on the underlying disease. We studied the factors associated with decreased survival and end-of-life characteristics in an unselected population of subjects starting NIV.</p><p><strong>Methods: </strong>We conducted a retrospective study including 205 subjects initiating NIV from 1/1/2012-31/12/2015 who were followed up until 31/12/2017.</p><p><strong>Results: </strong>The median survival time was shorter in subjects needing help with activities of daily living than in independent subjects (hazard ratio (HR) for death 1.7, 95% CI 1.2-2.6, <i>P</i> = 0.008) and was also shorter in subjects on long-term oxygen therapy (LTOT) than in those not on LTOT (HR for death 2.8, 95% CI 1.9-4.3, <i>P</i> < 0.001). There was marked difference in survival according to the disease necessitating NIV, and subjects with amyotrophic lateral sclerosis or interstitial lung disease seemed to have the shortest survival. The two most common diseases resulting in the need for NIV were chronic obstructive pulmonary disease (COPD) and obesity hypoventilation syndrome (OHS). The median survival time was 4.4 years in COPD subjects, but the median survival time was not reached in subjects with OHS (HR for death COPD vs. OHS: 3.2, 95% CI 1.9-5.5, <i>P</i> < 0.001). Most of the deceased subjects (55.6%) died in the hospital, while only 20.0% died at home. The last hospitalization admission leading to death occurred through the emergency room in 44.4% of the subjects.</p><p><strong>Conclusions: </strong>Survival among subjects starting NIV in this real-life study varied greatly depending on the disease and degree of functional impairment. Subjects frequently died in the hospital after admission through the emergency department. A comprehensive treatment approach with timely advance care planning is therefore needed, especially for those needing help with activities of daily living and those with both NIV and LTOT.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1840494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38713396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Danish severe asthma register: an electronic platform for severe asthma management and research.","authors":"Susanne Hansen, Ole Hilberg, Charlotte Suppli Ulrik, Uffe Bodtger, Linda M Rasmussen, Karin D Assing, Alexandra Wimmer-Aune, Kirsten B Rasmussen, Niels Bjerring, Anders Christiansen, Johannes Schmid, Niels Steen Krogh, Celeste Porsbjerg","doi":"10.1080/20018525.2020.1842117","DOIUrl":"10.1080/20018525.2020.1842117","url":null,"abstract":"<p><p>The evaluation and management of severe asthma patients require collection of comprehensive information, which is often a challenge in a busy outpatient clinic. The Danish Severe Asthma Register (DSAR) was designed as an electronic patient record form that captures operational clinical data and provides a clinical overview of the severe asthma patient. DSAR is a nationwide register; all patients in Denmark who are treated with biologics for severe asthma are included, and data are as a minimum entered at start of biological treatment, after four and 12 months of treatment, and hereafter annually. Currently, there are data from 621 treatment courses with biologics included in DSAR, with 71% of patients treated with anti-IL-5 drugs and 29% with an anti-IgE drug. Patients enter Patient Reported Outcome Measures electronically on tablets when they arrive in the outpatient clinic and their answers are immediately available to the clinician during the consultation. Nurses and doctors enter clinical data into DSAR during the consultation. DSAR offers immediate access to well-presented longitudinal overview and automatically creates a journal output that can be copy-pasted into the hospital's existing health record form. DSAR is also currently expanding with an app, to be used for monitoring of home-treatment. In addition to serving as an electronic patient record form, DSAR will also provide opportunities to monitor the real-life efficacy of biological treatment for severe asthma in Denmark, and it will be a valuable research platform that will aid in answering important research questions on severe asthma in the future.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1842117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38713397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remarkable benefits of intravenous immunoglobulin (IVIG) in a patient with polymyositis-associated acute interstitial lung disease.","authors":"Soran Peshbahar,&nbsp;Elisabeth Bendstrup","doi":"10.1080/20018525.2020.1840706","DOIUrl":"https://doi.org/10.1080/20018525.2020.1840706","url":null,"abstract":"<p><p>Polymyositis (PM) and dermatomyositis (DM) are subtypes of autoimmune inflammatory myopathies. Interstitial lung disease (ILD) involvement is common in PM/DM. There is no evidence base for immunosuppression in DM/PM-ILD and current evidence is based on case stories and expert opinions. We present a 63-year-old male with severe respiratory failure due to PM-ILD who was treated successfully with intravenous immunoglobulin, recovered the acute phase and survived more than 4 years.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1840706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Swedish National Airway Register (SNAR): development, design and utility to date.","authors":"C Stridsman, J R Konradsen, L Vanfleteren, C Pedroletti, J Binnmyr, P Edfelt, K Fjällman Schärberg, Y Sjöö, F Nyberg, A Lindberg, A Tunsäter, A Ekberg-Jansson","doi":"10.1080/20018525.2020.1833412","DOIUrl":"10.1080/20018525.2020.1833412","url":null,"abstract":"<p><strong>Background: </strong>The Swedish National Airway Register (SNAR) was initiated in 2013 to ensure and improve the quality of care for patients with asthma and COPD.</p><p><strong>Aim: </strong>To describe the development and design of SNAR, and to study the 2019 data to evaluate its potential utility related to improvement of quality of care.</p><p><strong>Methods: </strong>SNAR includes data from patients with asthma (both children and adults) and COPD from primary, secondary and tertiary care, and also, for COPD inpatient care. Data on diagnostic investigations (e.g. spirometry, blood sample, skin prick test), symptom-scores, comorbidities and prescribed treatments are registered. The registrations are entered manually by healthcare professionals, or directly transferred from electronic medical records to a web-based platform.</p><p><strong>Results: </strong>In 2019, 1000 clinics participated and data were directly transferred by about 88% of them. The register included data on 205,833 patients with asthma and 80,372 with COPD (of these, 5% had both diagnoses). Registrations of new patients and follow-up visits from primary and secondary/tertiary care in 2019 were completed for 75,707 patients with asthma (11,818 children <12 yr, 6545 adolescents 12-17 yr, and 57,344 adults >17 yr) and 38,117 with COPD. Depending on age and disease group, 43-77% had performed spirometry, 36-65% Asthma Control Test, and 60% COPD Assessment Test. The prevalence of current smoking was about 2% in adolescents, 10% in adults with asthma, and 34% in COPD. For these, smoking cessation support was offered to 27%, 38% and 51%, respectively. Overall, limited data were available on investigation of allergy, 6-min walk test, patient education and written treatment plans. Regarding asthma, sex-differences in disease management were evident.</p><p><strong>Conclusion: </strong>SNAR has cumulatively registered data from over 270,000 individuals, and the register is important for patients, caregivers, authorities, politicians and researchers to evaluate the effect of treatment and to ensure high and equal quality of care nationwide.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/d5/ZECR_7_1833412.PMC7594834.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of inhalation errors, training time and patient preference for DuoResp® Spiromax® and Symbicort® Turbuhaler® in patients with asthma and COPD.","authors":"Jordi Giner, Marta Villarnovo Cerrillo, Jaime Aboín Sierra, Laura Casas Herrero, Oliver Patino, Vicente Plaza","doi":"10.1080/20018525.2020.1833411","DOIUrl":"10.1080/20018525.2020.1833411","url":null,"abstract":"<p><p>While poor inhaler technique in asthma and chronic obstructive pulmonary disease (COPD) can compromise the effectiveness of inhaled medications, identifying and quantifying these errors may suggest ways to improve inhalation technique and patient outcomes. The objective of this international, multicentre care improvement programme was to investigate errors in inhaler use (handling errors and inhalation errors) made by patients in handling two dry powder inhalers; DuoResp® Spiromax® and Symbicort® Turbuhaler®. Patients with asthma or COPD aged between 18 and 80 years attending the allergology/pneumology departments of 14 hospitals in Spain and Portugal were included. All assessments were performed during one regular scheduled visit to the study clinic. Among 161 eligible patients (138 with asthma; 23 with COPD), inhalation errors were the most common type of error, with no significant difference between devices in overall total error rate, handling error rate or inhalation error rate. Significantly fewer total errors per patient (1.4 vs. 1.9; <i>p</i> < 0.001) and handling errors per patient (0.5 vs. 0.8; <i>p</i> < 0.001) were observed with DuoResp® Spiromax® compared with Symbicort® Turbuhaler®. The mean number of attempts for patients using DuoResp® Spiromax® to perform two correct procedures was 1.9 (0.6) compared with 2.1 (0.9) attempts for patients using Symbicort® Turbuhaler® (<i>p</i> = 0.016). Compared with Symbicort® Turbuhaler®, DuoResp® Spiromax® was found to be easy to learn how to use (<i>p</i> < 0.001), easy to prepare (<i>p</i> < 0.001), easy to use (<i>p</i> < 0.001), comfortable in terms of weight and size (<i>p</i> = 0.001), and patients felt that they were using the device correctly (<i>p</i> < 0.001). Overall, 79.5% of patients stated that they preferred DuoResp® Spiromax® as their first option over Symbicort® Turbuhaler®. The findings of this study may be useful in developing effective inhaler training programmes and thus improve outcomes in asthma and COPD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1833411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38659114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}