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Differences in clinical characteristics between coronavirus disease 2019 (COVID-19) and influenza: a systematic review and meta-analysis.
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-28 DOI: 10.1038/s41533-025-00414-0
Yingying Han, Jia Guo, Xingzhao Li, Zhuan Zhong
{"title":"Differences in clinical characteristics between coronavirus disease 2019 (COVID-19) and influenza: a systematic review and meta-analysis.","authors":"Yingying Han, Jia Guo, Xingzhao Li, Zhuan Zhong","doi":"10.1038/s41533-025-00414-0","DOIUrl":"10.1038/s41533-025-00414-0","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) epidemic has brought major challenges to the global health system, and influenza is also a problem that cannot be ignored. We aimed to explore and compare the clinical characteristics of COVID-19 and influenza to deepen the understanding of these two diseases and provide some guidance for clinicians to make differential diagnoses. We searched PubMed, Embase and Web of Science for articles and performed a meta-analysis using Stata 14.0 with a random-effects model. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. One hundred articles involving 226,913 COVID-19 patients and 201,617 influenza patients were included, and all the articles included patients with these two diseases as experimental and control groups. Compared to influenza, COVID-19 was more common among men (OR = 1.46, 95% CI: 1.23-1.74) and people with a higher body mass index (MD = 1.43, 95% CI: 1.09-1.77). The proportion of current smokers among COVID-19 patients was lower than that among influenza patients (OR = 0.25, 95% CI: 0.18-0.33). Patients with COVID-19 had longer stays in the hospital (MD = 3.20, 95% CI: 2.58-3.82) and ICU (MD = 3.10, 95% CI: 1.44-4.76), required mechanical ventilation more frequently (OR = 2.30, 95% CI: 1.77-3.00), and had higher mortality (OR = 2.22, 95% CI: 1.93-2.55). We also found significant differences in some blood parameters between the two groups of patients. Upper respiratory symptoms were more obvious in influenza patients, and the proportion of comorbidities was higher than that among COVID-19 patients. There are some differences in the major characteristics, symptoms, laboratory findings and comorbidities between COVID-19 patients and influenza patients. COVID-19 patients often require more medical resources and have worse clinical outcomes.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"8"},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059630","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}
引用次数: 0
Codeveloping a community-based, peer-led psychosocial support intervention to reduce stigma and depression among people with tuberculosis and their households in Indonesia: a mixed-methods participatory action study.
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-27 DOI: 10.1038/s41533-024-00407-5
Ahmad Fuady, Mariska Anindhita, Matsna Hanifah, Arieska Malia Novia Putri, Artasya Karnasih, Feranindhya Agiananda, Finny Fitry Yani, Marinda Asiah Nuril Haya, Trevino Aristaskus Pakasi, Tom Wingfield
{"title":"Codeveloping a community-based, peer-led psychosocial support intervention to reduce stigma and depression among people with tuberculosis and their households in Indonesia: a mixed-methods participatory action study.","authors":"Ahmad Fuady, Mariska Anindhita, Matsna Hanifah, Arieska Malia Novia Putri, Artasya Karnasih, Feranindhya Agiananda, Finny Fitry Yani, Marinda Asiah Nuril Haya, Trevino Aristaskus Pakasi, Tom Wingfield","doi":"10.1038/s41533-024-00407-5","DOIUrl":"10.1038/s41533-024-00407-5","url":null,"abstract":"<p><p>Evidence relating to peer support and community-based psychological and social (psychosocial) interventions to reduce stigma and depression among people with tuberculosis (TB) and their households is limited. This study aimed to engage with multisectoral stakeholders in Indonesia to co-develop a peer-led, community-based psychosocial intervention that is replicable, acceptable, and sustainable. We used a participatory action design and engaged key national, multisectoral stakeholders to ensure that the intervention co-design was relevant and appropriate to the TB health system and the sociocultural context of Indonesia. The co-design of the intervention evolved through four phases: (1) a scoping review to identify a long list of potential TB stigma reduction interventions; (2) a modified Delphi survey to define a shortlist of the potential interventions; (3) a national multisectoral participatory workshop to identify and pre-finalize the most viable elements of psychosocial support to distill into a single multi-faceted intervention; and (4) finalization of the intervention activities. The scoping review identified 12 potential intervention activities. These were then reduced to a shortlist of six potential intervention activities through a modified Delphi Survey completed by 22 multisectoral stakeholder representatives. At the national participatory workshop, the suitability, acceptability, and feasibility of the six potential intervention activities were discussed by the key stakeholders, and consensus reached on the final four activities to be integrated into the psychosocial support intervention. These activities consisted of: individual psychological assessment and counselling; monthly peer-led group counselling; peer-led individual support; and community-based TB Talks. In Indonesia, meaningful participation of multisectoral stakeholders facilitated co-design of a community-based, peer-led intervention to reduce TB stigma and depression amongst people with TB and their households. The intervention was considered to be locally appropriate and viable, and is being implemented and evaluated as part of the TB-CAPS intervention study.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"7"},"PeriodicalIF":3.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053077","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}
引用次数: 0
The availability of drugs for stable COPD treatment in China: a cross-sectional survey. 中国慢性阻塞性肺病稳定期治疗药物的供应情况:横断面调查。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-25 DOI: 10.1038/s41533-025-00413-1
Dongru Du, Xueru Hu, Qiunan Zuo, Dan Xu, Tao Zhu, Tao Fan, Jiao Yang, Weiguo Xu, Hailong Wei, Kangzhuo Baima, Ying Zhang, Yanhui Gu, Lei Chen, Fengming Luo, Yongchun Shen, Fuqiang Wen
{"title":"The availability of drugs for stable COPD treatment in China: a cross-sectional survey.","authors":"Dongru Du, Xueru Hu, Qiunan Zuo, Dan Xu, Tao Zhu, Tao Fan, Jiao Yang, Weiguo Xu, Hailong Wei, Kangzhuo Baima, Ying Zhang, Yanhui Gu, Lei Chen, Fengming Luo, Yongchun Shen, Fuqiang Wen","doi":"10.1038/s41533-025-00413-1","DOIUrl":"10.1038/s41533-025-00413-1","url":null,"abstract":"<p><p>This survey aimed to investigate the availability of drugs for stable chronic obstructive pulmonary disease (COPD) treatment in Chinese hospitals and to determine whether drug availability significantly varied among hospitals with different characteristics. A well-constructed questionnaire was designed according to the Chinese Guidelines for the Diagnosis and Management of COPD (revised version 2021). Both inhaled drugs (monotherapy, double therapy and triple therapy) and oral drugs (expectorants, theophylline, antibiotics, and bacterial lysates) were included in this survey. Doctors from different hospitals completed the survey via WeChat. The availability of each category and kind of drug was analyzed based on final valid responses. Subgroup analyses were also conducted to reveal drug availability in hospitals with different characteristics. A total of 1018 hospitals with different characteristics were enrolled in this survey, with 53.73% of which establishing independent respiratory departments. Insufficient supply of COPD-related drugs was observed, with only short-acting β2 agonists (80.6%), expectorants (88.2%) and antibiotics (84.3%) reaching 80%. Results of subgroup analyses suggested that primary hospitals were associated with poorer availability of all kinds of drugs than secondary and tertiary hospitals (all p < 0.001). Most inhaled drugs did not reach an availability of 20% in primary hospitals, except for salbutamol (59.7%), tiotropium bromide (20.0%) and beclometasone/formoterol (23.1%). Results of this survey suggested that the availability of drugs for COPD treatment in China is still an ongoing challenge for healthcare institutions. Insufficient drug supply and imbalanced drug availability among different hospitals are major barriers that warrant further improvements.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"6"},"PeriodicalIF":3.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040336","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}
引用次数: 0
"I'm living in a 'no' world now…"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population.
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-24 DOI: 10.1038/s41533-024-00409-3
Helene L Elliott-Button, Miriam J Johnson, Ann Hutchinson, David C Currow, Joseph Clark
{"title":"\"I'm living in a 'no' world now…\"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population.","authors":"Helene L Elliott-Button, Miriam J Johnson, Ann Hutchinson, David C Currow, Joseph Clark","doi":"10.1038/s41533-024-00409-3","DOIUrl":"10.1038/s41533-024-00409-3","url":null,"abstract":"<p><p>Chronic breathlessness is a debilitating symptom with detrimental impact on individuals and carers. However, little is known about the experiences of community-dwelling, frail, older adults living with chronic breathlessness. To explore, (i) the psychological impact of living with chronic breathlessness, (older frail adult patients, carers) and (ii) how patients, carers, and clinicians experience identification and assessment of chronic breathlessness in the primary care setting. In-depth semi-structured interviews with eligible older adults (≥65 years; moderate to severe frailty [electronic Frailty Index >0.36]), and carers recruited from a community-based Integrated Care Centre in England. Clinicians were recruited from the Centre and affiliated GP practices. Recorded in-person interviews were transcribed and subjected to reflexive thematic analysis using Total Dyspnoea and Breathing Space conceptual frameworks. 20 patients (9 females), carers (4 spouses, 1 daughter), and clinicians (5 GPs, 3 advanced clinical practitioners, 2 nurses) were interviewed. Four themes were identified: (1) Widespread negative impact of chronic breathlessness. Breathlessness adversely impacts physical and psychological wellbeing. (2) Barriers to optimal health-seeking and identification of chronic breathlessness. Breathlessness is 'one of many' symptoms, and not prioritised in 'one appointment, one problem' consultations. Clinicians do not routinely ask about breathlessness. Patients are unaware of breathlessness-specific therapies. (3) Variations in chronic breathlessness management. Management is limited; few are offered evidence-based treatments (e.g., handheld fan) and patients find their own strategies. (4) Need for education and information. Clinicians felt helpless about breathlessness management, and patients lacked understanding and had low expectations of receiving help for this symptom. Breathlessness adversely impacts the psychological wellbeing of older frail adults. Chronic breathlessness in older, frail adults is invisible, unidentified and unmanaged in primary care. Evidence-based breathlessness interventions are available, but not routinely implemented with few patients accessing them. Proactive identification, assessment and management of breathlessness in primary care is needed to support adults living with chronic breathlessness.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"5"},"PeriodicalIF":3.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040113","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}
引用次数: 0
The effect of allergic rhinitis treatment on asthma control: a systematic review. 变应性鼻炎治疗对哮喘控制的影响:系统综述。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-17 DOI: 10.1038/s41533-024-00408-4
Ellen Tameeris, Arthur M Bohnen, Patrick J E Bindels, Gijs Elshout
{"title":"The effect of allergic rhinitis treatment on asthma control: a systematic review.","authors":"Ellen Tameeris, Arthur M Bohnen, Patrick J E Bindels, Gijs Elshout","doi":"10.1038/s41533-024-00408-4","DOIUrl":"10.1038/s41533-024-00408-4","url":null,"abstract":"<p><p>Asthma and allergic rhinitis (AR) are common disorders of the respiratory tract that often coincide. Control of AR symptoms can improve asthma outcomes in patients with co-existing diseases. Our aim is to produce a systematic review of the effectiveness of conventional anti-AR medication for asthma outcomes in patients with both diseases. The Embase, Medline and Cochrane databases were searched for publications up to October 2024. Randomised controlled trials (RCTs) that reported objective (OAO) or subjective asthma outcomes (SAO) and compared the efficacy of anti-AR medication to placebo or conventional asthma medication were included. Included medication interventions were antihistamines (AH), corticosteroids and leukotriene receptor antagonists (LRA). We included thirty-three RCTs. Six had an exclusively paediatric study population, 17 a partially paediatric study population. No clinically relevant improvements were seen in SAO. Quality of life (QoL) showed a significant and clinically relevant improvement in five studies. A significant and clinically relevant improvement of OAO was seen in four studies. LRAs did not show significant improvements from baseline. When compared, corticosteroids performed significantly better than LRAs. Significant improvements in both OAO and SAO were seen more often in studies with AHs than with corticosteroids. Anti-allergic initiated AHs and corticosteroids seemed to have a positive effect on asthma outcomes, with AHs having the tendency to elicit more changes in outcomes than the other studied medication groups. LRAs do not seem to influence asthma outcomes. Most significant improvements were seen in QoL and OAO. SAO did not show clinically relevant improvements.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"4"},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009108","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}
引用次数: 0
Smoking status, symptom significance and healthcare seeking with lung cancer symptoms in the Danish general population. 丹麦普通人群吸烟状况、症状意义和肺癌症状的求医
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-10 DOI: 10.1038/s41533-025-00412-2
Lisa Maria Sele Sætre, Kirubakaran Balasubramaniam, Jens Søndergaard, Dorte Ejg Jarbøl
{"title":"Smoking status, symptom significance and healthcare seeking with lung cancer symptoms in the Danish general population.","authors":"Lisa Maria Sele Sætre, Kirubakaran Balasubramaniam, Jens Søndergaard, Dorte Ejg Jarbøl","doi":"10.1038/s41533-025-00412-2","DOIUrl":"10.1038/s41533-025-00412-2","url":null,"abstract":"<p><p>This study analyses the associations between smoking status and perceived symptom significance (concern and influence on daily activity) among individuals with possible lung cancer symptoms and investigate the influence of symptom significance on healthcare seeking among individuals with different smoking status. A nationwide survey with 21,920 randomly selected individuals aged ≥40 years included questions about lung cancer symptoms, symptom concern and influence on daily activities, GP contact, and smoking status. Descriptive statistics and multivariable regression models were applied. Overall, individuals who currently smoked were more likely to perceive their lung cancer symptoms as significant, and individuals who reported high symptom significance were more likely to seek healthcare with both specific and non-specific symptoms. The significance of symptoms appeared to have less pronounced effect on prompting healthcare seeking among individuals with a history of current smoking. This implies that they may benefit from support and encouragement to seek care.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"3"},"PeriodicalIF":3.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965772","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}
引用次数: 0
Author Correction: Best practice advice for asthma exacerbation prevention and management in primary care: an international expert consensus. 作者更正:在初级保健中预防和管理哮喘加重的最佳实践建议:国际专家共识。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-09 DOI: 10.1038/s41533-024-00411-9
Neil Skolnik, Barbara P Yawn, Jaime Correia de Sousa, María Mar Martínez Vázquez, Amanda Barnard, Wendy L Wright, Austin Ulrich, Tonya Winders, Stephen Brunton
{"title":"Author Correction: Best practice advice for asthma exacerbation prevention and management in primary care: an international expert consensus.","authors":"Neil Skolnik, Barbara P Yawn, Jaime Correia de Sousa, María Mar Martínez Vázquez, Amanda Barnard, Wendy L Wright, Austin Ulrich, Tonya Winders, Stephen Brunton","doi":"10.1038/s41533-024-00411-9","DOIUrl":"10.1038/s41533-024-00411-9","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"2"},"PeriodicalIF":3.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952160","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}
引用次数: 0
Description and characterization of pneumococcal community acquired pneumonia (CAP) among radiologically confirmed CAP in outpatients. 门诊放射学证实的肺炎球菌社区获得性肺炎(CAP)的描述和特征。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2025-01-04 DOI: 10.1038/s41533-024-00405-7
Josselin Le Bel, Juliette Pinot, Toni Alfaiate, Marie Ecollan, Fanny Cussac, Raphaël Pecqueur, Marie-Pierre Revel, Cyrille Vartanian, Emmanuelle Varon, Christian Theilacker, Xavier Duval, Henri Partouche, Cédric Laouénan, Serge Gilberg
{"title":"Description and characterization of pneumococcal community acquired pneumonia (CAP) among radiologically confirmed CAP in outpatients.","authors":"Josselin Le Bel, Juliette Pinot, Toni Alfaiate, Marie Ecollan, Fanny Cussac, Raphaël Pecqueur, Marie-Pierre Revel, Cyrille Vartanian, Emmanuelle Varon, Christian Theilacker, Xavier Duval, Henri Partouche, Cédric Laouénan, Serge Gilberg","doi":"10.1038/s41533-024-00405-7","DOIUrl":"10.1038/s41533-024-00405-7","url":null,"abstract":"<p><p>Streptococcus pneumoniae (SP) remains an important cause of community acquired pneumonia (CAP). We aimed to describe the prevalence and characteristics of outpatients with radiologically confirmed pneumococcal CAP. Between November 2017 and December 2019, a French network of general practitioners enrolled CAP-suspected adults, with ≥1 clinical signs of infection and ≥1 signs of pulmonary localization in an observational study. Pneumococcal CAP was defined by the combination of a chest X-ray (CXR) compatible with CAP and SP detection by any of four microbiological tests (blood culture, sputum culture, pneumococcal urinary antigen test [BinaxNow®] and serotype-specific multiplex urinary antigen detection test [Pfizer Inc®]. To identify other pathogens, next to cultures, nasopharyngeal multiplex PCR was performed. Three hundred and forty-eight patients were included, of whom 144 had a positive CXR, 135/144 (93.8%) had not received antibiotics prior to inclusion, 21/144 (14.6%) had ≥1 positive microbiological test for SP, and 66/144 (45.8%) were negative for all four microbiological tests and were considered as non-pneumococcal CAP. Pneumococcal serotypes were identified for 12 patients. This study assessing the prevalence of SP among CAP outpatients using comprehensive microbiologic testing shows that SP is still the most frequently identified microorganism.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927649","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}
引用次数: 0
Clinically-enhanced digital health program for respiratory care associated with better medication use and retention. 与更好的药物使用和保留相关的呼吸护理临床增强数字健康计划。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2024-12-28 DOI: 10.1038/s41533-024-00404-8
Leanne Kaye, Vy Vuong, Urvashi Patel, Douglas Mager, Meredith A Barrett
{"title":"Clinically-enhanced digital health program for respiratory care associated with better medication use and retention.","authors":"Leanne Kaye, Vy Vuong, Urvashi Patel, Douglas Mager, Meredith A Barrett","doi":"10.1038/s41533-024-00404-8","DOIUrl":"10.1038/s41533-024-00404-8","url":null,"abstract":"<p><p>Digital health platforms for asthma self-management have demonstrated promise in improving clinical and quality of life outcomes. However, few studies have examined such an approach in a real-world, fully remote setting. As such, we evaluated the benefit of an evidence-based digital self-management platform for asthma-both on its own and when integrated into an established virtual clinical service. We compared six-month outcomes of a digital self-management program plus virtual clinical oversight, called a therapeutic resource center, (DP + TRC) with a digital self-management-only (DP) program in patients with uncontrolled asthma. The DP included electronic medication sensors that captured the date and time of both short-acting beta agonist (SABA) and controller medication usage. The TRC included remote care oversight to promote inhaler adherence and address symptom worsening. SABA usage, controller adherence and program retention were assessed retrospectively using regression models controlling for age, enrollment year, controller/SABA use, and baseline asthma control status.18,584 DP patients (mean age (SD): 33 (14.6) yrs; 89.9% uncontrolled asthma) and 3440 DP + TRC patients (mean age (SD): 43.7 (15.6) yrs); 48.6% uncontrolled) were assessed. We observed significantly better six-month program retention (55% vs. 41%, p < 0.001) and controller adherence (54% vs. 45%, p < 0.001), but no statistically significant differences in mean SABA use (0.76 vs. 0.87 mean puffs/day; p = 0.158) for the DP + TRC vs. DP groups, respectively. From baseline to six months, both groups had similar reductions in mean daily SABA use (both p < 0.001) and improvements in the percent of SABA-free days (both p < 0.001). The proportion of patients with ≥80% controller adherence declined in both groups, but a larger relative decline was noted in the DP vs. DP + TRC group. A digital self-management platform for asthma management combined with virtual clinical oversight may offer a scalable solution that not only achieves reduced SABA use, but also promotes medication adherence and increases program retention.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"46"},"PeriodicalIF":3.1,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896317","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}
引用次数: 0
A practical guide to the diagnosis and management of suspected Non-tuberculous Mycobacterial Pulmonary Disease (NTM-PD) in the United Kingdom. 在英国诊断和管理疑似非结核分枝杆菌肺病(NTM-PD)的实用指南。
IF 3.1 3区 医学
NPJ Primary Care Respiratory Medicine Pub Date : 2024-12-21 DOI: 10.1038/s41533-024-00403-9
D J Dhasmana, P Whitaker, R van der Laan, F Frost
{"title":"A practical guide to the diagnosis and management of suspected Non-tuberculous Mycobacterial Pulmonary Disease (NTM-PD) in the United Kingdom.","authors":"D J Dhasmana, P Whitaker, R van der Laan, F Frost","doi":"10.1038/s41533-024-00403-9","DOIUrl":"10.1038/s41533-024-00403-9","url":null,"abstract":"<p><p>Non-tuberculous Mycobacterial Pulmonary Disease (NTM-PD) is a chronic disease characterised by progressive inflammatory lung damage due to infection by non-tuberculous mycobacteria (NTM). Global prevalence of NTM-PD is generally low but is rising, likely due to a combination of increased surveillance, increasing multimorbidity and improved diagnostic techniques. Most disease is caused by Mycobacterium avium complex species. NTM-PD can be challenging to both diagnose and manage but given the risk of untreated disease and the challenges around drug treatments, it is vital that all healthcare professionals involved in primary care consider NTM-PD at the earliest opportunity. In particular, NTM-PD should be considered where there are respiratory symptoms in the setting of pre-existing chronic lung disease such as chronic obstructive pulmonary disease (COPD) and bronchiectasis. Early suspicion should lead to appropriate primary screening measures. This article discusses the relevance of NTM-PD today, risk factors for developing disease, pathways from clinical presentation to referral to specialist care, and discusses management and drug treatments. A flow diagram of a screening process is presented as a guideline for best practice from a United Kingdom perspective.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"45"},"PeriodicalIF":3.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872563","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}
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