NPJ Primary Care Respiratory Medicine最新文献

{"title":"Cardiometabolic risk and mortality in PRISm versus COPD: a systematic review and meta-analysis.","authors":"Han-Ye Deng, Xin-Yue Ran, Rong Qian","doi":"10.1038/s41533-026-00535-0","DOIUrl":"https://doi.org/10.1038/s41533-026-00535-0","url":null,"abstract":"<p><p>To evaluate and compare the risks of cardiometabolic comorbidities and all-cause mortality between individuals with preserved ratio impaired spirometry (PRISm) and those with chronic obstructive pulmonary disease (COPD). A systematic literature search was conducted across CNKI, Wanfang Database, VIP Database, SinoMed, PubMed, Embase, Web of Science, and the Cochrane Library from inception to February 2026 to identify observational studies comparing PRISm (FEV₁/FVC ≥ 0.70 and FEV₁ < 80% predicted) with COPD (FEV₁/FVC < 0.70). Meta-analysis was performed using RevMan 5.4. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models, and subgroup analyses were conducted by geographic region. Twenty-two observational studies (n = 343,849) were included, involving 125,776 participants with PRISm and 218,073 with COPD. Compared with COPD, PRISm was associated with significantly higher risks of cardiometabolic conditions, including diabetes [OR = 1.56, 95% CI (1.34-1.82)], obesity [OR = 1.72, 95% CI (1.10-2.68)], and hypertension [OR = 1.15, 95% CI (1.09-1.21)] (P < 0.05). No significant differences were found regarding heart failure, coronary heart disease, or all-cause mortality (P > 0.05). Subgroup analyses revealed that diabetes risk was higher in Western populations (P = 0.002), while all-cause mortality was lower in the PRISm group than in the COPD group specifically among Asian populations (P < 0.001). PRISm is associated with higher risks of hypertension, diabetes, and obesity compared with COPD, highlighting cardiometabolic dysfunction as an important clinical feature. Although the all-cause mortality risk of PRISm was comparable to that of COPD, ethnic heterogeneity was observed in its clinical characteristics. These findings suggest that PRISm may represents a clinically important and heterogeneous lung function phenotype requiring greater clinical attention.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295836","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":"Global Asthma Burden due to Attributable Risk Factors, 1990-2021, and Forecast to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021.","authors":"Qiming Dai, Jin Xiang","doi":"10.1038/s41533-026-00530-5","DOIUrl":"10.1038/s41533-026-00530-5","url":null,"abstract":"<p><strong>Background: </strong>Asthma, a common chronic respiratory disease worldwide, is strongly influenced by several attributable risk factors.</p><p><strong>Objective: </strong>To systematically examine global asthma burden trends attributable to major risk factors from 1990 to 2021 and forecast changes to 2050.</p><p><strong>Methods: </strong>Using 2021 GBD data, we estimated global asthma DALYs and age-standardized DALY rates (ASDRs) attributable to high BMI, smoking, occupational exposure, and NO₂ pollution, and explored their relationships with the Socio-demographic Index (SDI). Bayesian age-period-cohort (BAPC) modeling was used for forecasting, with 1990-2010 data serving as the training set for backtesting trends from 2011 to 2021, and with prediction accuracy evaluated with the mean absolute percentage error (MAPE).</p><p><strong>Results: </strong>During 1990-2021, asthma burden related to most risk factors declined globally and across SDI quintiles. Backtesting confirmed BAPC model reliability (MAPE: high BMI 5.44%, smoking 1.16%, occupational asthmagens 3.35%). Worldwide, smoking-related burden declined most sharply: ASDR fell from 41.95 in 1990 to 16.19 in 2021 per 100,000 (-61.41%, estimated annual percentage change [EAPC] = -3.13). NO₂ pollution and occupational asthma burdens dropped 48.45% and 45.57%, respectively. High BMI showed the smallest reduction (-21.99%, EAPC = -0.85) and showed an increase in low-middle SDI regions (EAPC = 0.25). ASDRs for high BMI (ρ = -0.27), occupational risks, and smoking correlated negatively with SDI; NO₂ ASDR showed a significant positive correlation with SDI (ρ = 0.56, P < 0.001). By 2050, high BMI is projected to be the only risk factor with a continuously rising burden, with its ASDR rising from 39.42 in 2021 to 53.79 per 100,000 ( + 36.45%).</p><p><strong>Conclusion: </strong>Despite declines in asthma burden from all four factors, high BMI poses a growing threat with significant regional disparities. Future strategies should be tailored by SDI region and high-risk population, prioritizing surveillance and intervention for high BMI to counter its rising disease risk.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252564","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":"Supporting referral to pulmonary rehabilitation from primary care: A systematic evaluation of interventions using the ERIC taxonomy.","authors":"Sarah Hug, Sanduni Madawala, Arwel W Jones, Caitlin Dumergue, Anne E Holland, Narelle S Cox","doi":"10.1038/s41533-026-00531-4","DOIUrl":"10.1038/s41533-026-00531-4","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary rehabilitation (PR) is a key component in managing chronic respiratory diseases (CRDs). Primary care, often the first point of contact for people with CRD, is well-positioned to facilitate referral to PR, yet referral rates are low. This systematic review aimed to identify the key components of primary care interventions to support referral to PR and synthesise their effect on referral rate.</p><p><strong>Methods: </strong>Five electronic databases were searched to identify studies of any design that reported interventions implemented in primary care to support referral to PR for people with CRD. Interventions could target people with CRD and/or healthcare professionals. Screening, quality appraisal using the Downs and Black checklist, and data extraction were conducted independently by two reviewers. Interventions were mapped to the Expert Recommendations for Implementing Change (ERIC) taxonomy-a framework of 73 strategies seeking to enhance the adoption, implementation, and sustainability of evidence-based interventions.</p><p><strong>Results: </strong>Thirteen studies were included, employing a range of quasi-experimental, observational, and randomised designs. Overall, the studies were of moderate quality (mean total score 14, range 10 to 25 out of 27). Interventions incorporated a mean of 12 ERIC strategies across five domains, most commonly education and training, interactive assistance, clinician support, and audit and feedback. Impact of interventions on referral rates was minimal (n = 3 randomised controlled trials, pooled mean difference 0%, 95% confidence interval -0.24 to 0.25).</p><p><strong>Interpretation: </strong>Multi-component interventions, including numerous implementation strategies, have achieved minimal improvement in PR referral rates from primary care. Understanding how strategies are delivered and applied, rather than simply the number of strategies or the combination they are used in, may be important for operationalisation of referral focussed interventions. Addressing the behavioural processes underpinning referral decisions, together with the use of theory-informed, context-specific approaches may enhance effectiveness of referral focussed interventions.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218536","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 European respiratory society guideline for adult bronchiectasis 2025: summary and implementation guide for primary care.","authors":"Fiona Mosgrove, Janwillem Wh Kocks, Eliza Kompatsiari, Alan Timothy, Tanja Hedberg, Merete B Long, Stefano Aliberti, James D Chalmers","doi":"10.1038/s41533-026-00528-z","DOIUrl":"10.1038/s41533-026-00528-z","url":null,"abstract":"<p><p>Bronchiectasis is a common chronic respiratory disease with rising prevalence, hospitalisation rates, and mortality. It is estimated to affect approximately 1 in 200 adults, imposing a substantial symptom burden and significant healthcare costs, largely driven by exacerbations. Although diagnosis and long-term management are usually led by respiratory specialists, most patient care interactions occur in primary care, including the management of multimorbidity and acute exacerbations. In December 2025, the European Respiratory Society (ERS) published updated global clinical practice guidelines for adult bronchiectasis. This article summarises the 2025 ERS recommendations with a specific focus on their implementation in primary care practice. Key priorities include improving early recognition and reducing diagnostic delay, undertaking standardised investigations to identify underlying causes and treatable traits, and recognising features associated with poor outcomes that warrant specialist referral. The guidance emphasises the importance of sputum microbiology, including testing for non-tuberculous mycobacteria, and targeted blood investigations such as immunoglobulins and allergic bronchopulmonary aspergillosis serology. Core management strategies relevant to primary care are reviewed, including airway clearance techniques, pulmonary rehabilitation, and evidence-based use of inhaled therapies. The article outlines best practice for the management of acute exacerbations, highlights differences from asthma and COPD care, and clarifies the limited role of inhaled corticosteroids in bronchiectasis. The identification and monitoring of patients who may benefit from long-term antibiotic therapy, including those with Pseudomonas aeruginosa infection, are also discussed. By translating specialist guideline recommendations into a primary care context, this summary aims to support timely diagnosis, optimise ongoing management, and improve outcomes for adults with bronchiectasis.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205688","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 lung cancer and chronic obstructive pulmonary disease and associated risk factors, 1990-2021: results from the global burden of disease study 2021.","authors":"Jing Qian, Sheng Zhou, Rong Wang, Qian Wu, Jinliang Meng, Jun Zhang, Yunhui Zhang","doi":"10.1038/s41533-026-00526-1","DOIUrl":"10.1038/s41533-026-00526-1","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are fatal respiratory diseases with shared pathophysiological mechanisms. However, their global burden patterns remain insufficiently characterized within a comparative framework. This study aimed to conduct a comprehensive comparative global burden analysis of LC and COPD.</p><p><strong>Methods: </strong>Using Global Burden of Disease (GBD) study data(1990-2021), we analyzed LC and COPD burden (incidence, prevalence, mortality, and disability-adjusted life years (DALYs)), identified their associated risk factors, elucidated temporal trends, and projected future burden from 2022 to 2050.</p><p><strong>Results: </strong>In 2021, significant geographical variations in the burden of LC and COPD were observed, with LC predominantly burdening high-income European and Oceanian regions and COPD concentrated in low-to-middle-income Asian and Oceanian countries. Ten shared risk factors were identified for both diseases, among which tobacco use, smoking, ambient and household air pollution, occupational carcinogen exposure, and particulate matter pollution were the most common and prominent. Demographically, both diseases were concentrated in the elderly, peaking at slightly older ages, with LC showing more pronounced male predominance than COPD. From 1990-2021, females LC burden, rost most regions,whereas COPD burden declined globally across genders. Socioeconomically, socio-demographic index (SDI) was positively correlated with LC burden, but negatively correlated with COPD mortality and disability. High-SDI regions experienced a decline in LC and COPD declines, contrasting with the rising COPD prevalence in low-to-middle SDI regions. Projections (2022-2050) indicate declining LC incidence, mortality, and DALY rates (age-standardized incidence rate (ASIR) from 26.43 to 22.18 per 100,000 by 2050), with stable prevalence. All COPD metrics are projected to decrease (age-standardized mortality rate (ASMR) from 45.22 to 20.83 per 100,000 by 2050).</p><p><strong>Conclusion: </strong>This study presented a comprehensive comparative analysis of the global burden of LC and COPD, offering descriptive and comparative epidemiological evidence to inform tailored, disease-specific and region-specific prevention and control efforts.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163872","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":"How to quickly determine whether patients with chronic cough need corticosteroid treatment--construction of a predictive model for corticosteroid-responsive cough in chronic cough.","authors":"Baiyi Yi, Haodong Bai, Shujie Li, Tongyangzi Zhang, Yiqing Zhu, Wenxiu Luo, Xianghuai Xu, Li Yu","doi":"10.1038/s41533-026-00527-0","DOIUrl":"10.1038/s41533-026-00527-0","url":null,"abstract":"<p><p>Patients with chronic cough need to undergo a wide range of tests and rely on empirical medication to determine the underlying cause. Corticosteroid-responsive cough (CRC) accounts for the majority of the causes of chronic cough, and the diagnostic process is relatively complicated. To develop a predictive model for diagnosis of CRC, which is based on readily available clinical information. A retrospective dataset of 304 cases was used for training, and a prospective dataset of 131 cases was used for temporal single-center validation. Candidate predictors were screened via univariate analysis and refined using LASSO regression. A final multivariable model was constructed through stepwise logistic regression and presented as a clinical nomogram. The model's performance was rigorously evaluated in terms of discrimination (AUC-ROC), calibration (calibration curve), and clinical utility (decision curve analysis). The robustness of the model predictors was further supported by their consistency with the key variables identified by an optimal machine learning model. Of 20 candidate variables based on patient basic information and test results, 7 variables were selected as optimal predictors to establish a CRC prediction model for chronic cough, including reflux symptoms, history of allergic diseases, blood eosinophils, IgE, CRP, FEV₁/FVC, and FeNO₅₀. The model demonstrated good discrimination and calibration in both the training set (AUC = 0.900 [0.865,0.935], MAE = 0.017) and the validation set (AUC = 0.840 [0.771,0.909], MAE = 0.046). The results of decision curve analysis revealed that using our models to predict CRC in chronic cough would add more benefit than either the treat-all scheme or the treat-none scheme. The variable selection for the nomogram was further validated by the high degree of agreement with the feature importance rankings derived from the top-performing machine learning model (Random Forest). Our study has developed a nomogram model, along with a simplified version, based on easily accessible clinical information and pulmonary function tests. The model demonstrates strong predictive performance and good calibration, providing clinicians with a rapid aid for initiating targeted treatment.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157533","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":"Pre-school wheeze treatment patterns in the primary care setting in Italy.","authors":"Benedetta Canova, Anna Cantarutti, Riccardo Boracchini, Valentina Agnese Ferraro, Elisa Barbieri","doi":"10.1038/s41533-026-00520-7","DOIUrl":"10.1038/s41533-026-00520-7","url":null,"abstract":"<p><p>Wheeze is one of the most common respiratory conditions in early childhood. Despite available guidelines, treatment management in pre-school children remains challenging. We aim to describe prescribing patterns for pre-schoolers with wheeze in primary care settings. This retrospective population-based birth cohort study analyzed data from the Italian Pedianet primary care database. Children born between 2010 and 2017 and followed from birth to at least 5 years were included. Wheeze episodes were identified through ICD-9-CM codes and validated free-text searches in outpatient records. Prescribing patterns across successive episodes were analyzed using State Sequence Analysis (SSA), overall and stratified by age at first episode, to describe treatment trajectories in primary care from 2010 to 2023. Among 66,981 eligible children, 24.28% experienced at least one wheeze episode. Treatment was provided in 64.96% of episodes, with a median of two treated episodes per child. Initial prescribing showed considerable variation: inhaled beta2-agonists, oral corticosteroids, and inhaled corticosteroids were most commonly used, either alone or combined. Prescribing patterns varied by age, with greater use of inhaled therapies in older children. SSA showed declining numbers of children receiving subsequent treatments and a progressive consolidation toward a limited number of therapeutic regimens over successive episodes. In this primary care cohort, prescribing for pre-school wheeze was heterogeneous and influenced by age at first diagnosis. These findings highlight gaps between real-world practice and current guidelines, emphasizing the need for clearer guidance and targeted implementation strategies for managing wheeze in early childhood.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056034","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":"Patient attitudes, beliefs, and practices in environmentally friendly inhaler disposal: a mixed-methods evaluation with behaviourally informed recommendations.","authors":"Delyth James, Terence J McElvaney, Thomas Henstock, Hannah Thomas, Aleysha Caffoor, Alys Harrop, Sarah Brown, Catherine Heidi Seage","doi":"10.1038/s41533-026-00521-6","DOIUrl":"10.1038/s41533-026-00521-6","url":null,"abstract":"<p><p>The National Health Service (NHS) aims to reduce emissions from inhalers, a major contributor to its carbon footprint. Despite willingness, patient awareness and engagement with appropriate inhaler disposal and recycling remains low. This paper combines two studies both using the Capability, Opportunity, Motivation-Behaviour (COM-B) model with contrasting methodological approaches to explore inhaler disposal behaviours, and barriers and facilitators to recycling uptake. Synthesis of two datasets from quantitative (Study 1) and qualitative (Study 2) studies was undertaken, using deductive analysis (i.e. categorisation of barriers/facilitators from both studies and comparison to each COM-B component) to identify patterns across both studies inhaler users were unaware of the need to return inhalers to pharmacies for disposal and often discarded them in domestic waste. Inhaler users viewed community pharmacies as convenient locations for recycling schemes due to their proximity to the local pharmacy. However, they were unlikely to engage with initiatives that require significant additional effort such as traveling out of their way to return inhalers. Although awareness of environmental impacts can motivate intentions to recycle, users reported struggling to develop and maintain consistent recycling habits. Barriers to appropriate inhaler disposal were therefore evident across psychological capability (limited knowledge), physical opportunity (access and convenience), and automatic motivation (habitual disposal practices). These findings highlight persistent gaps between positive environmental intentions and actual disposal behaviours among inhaler users and the complexity of behaviour change, requiring interventions that address psychological, physical, motivational, environmental and social barriers. Future research should focus on implementing behaviourally informed approaches and evaluating these interventions to identify the most effective methods for improving inhaler disposal and reducing the environmental impact of inhaler use.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006074","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":"Reflections on 10 years of research capacity building.","authors":"Gwyneth A Davies, Hilary Pinnock, Kathryn Ferris, Aziz Sheikh","doi":"10.1038/s41533-026-00484-8","DOIUrl":"10.1038/s41533-026-00484-8","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"36 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988356","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 factors associated with severely reduced health status in patients with COPD and comorbid depression/anxiety: The Swedish PRAXIS study.","authors":"Therese Öfverholm, Mikael Hasselgren, Karin Lisspers, Anna Nager, Gabriella Eliason, Maaike Giezeman, Christer Janson, Marta A Kisiel, Scott Montgomery, Björn Ställberg, Josefin Sundh, Hanna Sandelowsky","doi":"10.1038/s41533-026-00522-5","DOIUrl":"10.1038/s41533-026-00522-5","url":null,"abstract":"<p><p>Patients with COPD and comorbid depression/anxiety are at risk of reduced health status. This study aimed to assess health status in COPD patients with depression/anxiety, the occurrence of severely reduced health status in this group, and to investigate associations between severely reduced health status and patient-related clinical factors. This cross-sectional study included 2245 randomly selected COPD patients from primary care and hospital outpatient clinics in Sweden. The COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ) were used to assess health status. Severely reduced health status was defined as CAT ≥ 20 or CCQ ≥ 2. The 524 patients (23.3%) who reported depression/anxiety had higher mean CAT scores (18.3 vs. 15.2, p < 0.001) and CCQ scores (2.37 vs. 1.83, p < 0.001) than patients without depression/anxiety. In this group, 48% had CAT ≥ 20 and 57% had CCQ ≥ 2. In patients with depression/anxiety, factors associated with CAT ≥ 20 were: onset of COPD symptoms before 60 years of age (OR = 2.62 [95% CI 1.37-5.04]), frequent symptoms of depression in the previous three months (2.59 [1.55-4.30]), one or more COPD exacerbations in the previous six months (2.37 [1.41-4.00]) and physical inactivity (1.89 [1.11-3.22]). Apart from physical inactivity, factors associated with CCQ ≥ 2 were the same as for CAT ≥ 20. Approximately half of the COPD patients with comorbid depression/anxiety reported severely reduced health status. Exacerbations, frequent depressive symptoms and physical inactivity were factors associated with severely reduced health status, and constitute important treatable and preventable traits of COPD.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"36 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960208","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}