NPJ Primary Care Respiratory Medicine最新文献

{"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}

{"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}

{"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}

{"title":"A 7-point evidence-based care discharge protocol for patients hospitalized for exacerbation of COPD: consensus strategy and expert recommendation.","authors":"Sundeep Salvi, Deesha Ghorpade, Sanjeev Nair, Lancelot Pinto, Ashok K Singh, K Venugopal, Raja Dhar, Deepak Talwar, Parvaiz Koul, Pralhad Prabhudesai","doi":"10.1038/s41533-024-00378-7","DOIUrl":"10.1038/s41533-024-00378-7","url":null,"abstract":"<p><p>Acute exacerbations of COPD (ECOPD) are an important event in the life of a COPD patient as it causes significant deterioration of physical, mental, and social health, hastens disease progression, increases the risk of dying and causes a huge economic loss. Preventing ECOPD is therefore one of the most important goals in the management of COPD. Before the patient is discharged after hospitalization for ECOPD, it is crucial to offer an evidence-based care bundle protocol that will help minimize the future risk of readmissions and death. To develop the content of this quality care bundle, an Expert Working Group was formed, which performed a systematic review of literature, brainstormed, and debated on key clinical issues before arriving at a consensus strategy that could help physicians achieve this goal. A 7-point consensus strategy was prepared, which included: (1) enhancing awareness and seriousness of ECOPD, (2) identifying patients at risk for future exacerbations, (3) optimizing pharmacologic treatment of COPD, (4) identifying and treating comorbidities, (5) preventing bacterial and viral infections, (6) pulmonary rehabilitation, and (7) palliative care. Physicians may find this 7-point care bundle useful to minimize the risk of future exacerbations and reduce morbidity and mortality.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"44"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872559","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":"Effect of Baduanjin exercise on health and functional status in patients with chronic obstructive pulmonary disease: a community-based, cluster-randomized controlled trial.","authors":"Yong Chen, Pan Zhang, Zongmei Dong, Yanan Zhu, Yanan Liu, Cheng Qiao, Ning Zhang, Yixue Jiang, Bi Chen","doi":"10.1038/s41533-024-00400-y","DOIUrl":"10.1038/s41533-024-00400-y","url":null,"abstract":"<p><p>Baduanjin has been shown to be an effective method of exercise for promoting body function in patients with chronic obstructive pulmonary disease (COPD). However, this method is rarely used by rural doctors in rural communities. The aim of this study was to compare the therapeutic effects of Baduanjin exercise with those of conventional pulmonary rehabilitation (CPR) implemented by rural doctors in patients with COPD. A total of 472 COPD patients from 18 village clinics were randomly allocated to the Baduanjin group (n = 158), CPR group (n = 154), or control group (n = 160). The Baduanjin group received six months of Baduanjin training, the CPR group received six months of rehabilitation training, and the control group received usual care. The primary outcomes were changes in health status, as measured by the COPD Assessment Test (CAT), and dyspnoea, as assessed via the modified Medical Research Council (mMRC) dyspnoea scale. The secondary outcomes included six-minute walking distance (6MWD) performance and anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively). Baseline data were collected before randomization, and outcomes were ascertained at the six-month follow-up by blinded assessors. After six months of training, compared with the control group, the Baduanjin group presented significant improvements in CAT scores (t = 5.121, P < 0.001), mMRC scale scores (t = 5.719, P < 0.001), 6MWD performance (t = 12.608, P < 0.001), HADS-A scores (t = 6.210, P < 0.001), and HADS-D scores (t = 2.945, P = 0.010). The CPR group also presented significant improvements in CAT scores (t = 4.725, P < 0.001), mMRC scale scores (t = 5.499, P < 0.001), 6MWD performance (t = 11.662, P < 0.001), HADS-A scores (t = 5.697, P < 0.001), and HADS-D scores (t = 2.671, P = 0.023). In contrast, the control group participants showed no significant changes in CAT scores (t = -0.252, P = 0.801), mMRC scale scores (t = -0.085, P = 0.932), 6MWD performance (t = -0.463, P = 0.644), HADS-A scores (t = -2.75, P = 0.783), or HADS-D scores (t = -0.281, P = 0.779). No adverse events were reported during the study. The positive effects of Baduanjin exercise on the subjective symptoms of COPD patients are similar to those of CPR. The trial was registered with the Chinese Clinical Trials Registry (reference: ChiCTR-TRC-12001958) (22/02/2012).</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"43"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864919","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":"Improving asthma care in children: revealing needs and bottlenecks through in-depth interviews.","authors":"Casper E W Gijsen, Carolien van Rossem, Jean W M Muris, Marieke W P van Horck, Edward Dompeling","doi":"10.1038/s41533-024-00406-6","DOIUrl":"10.1038/s41533-024-00406-6","url":null,"abstract":"<p><p>Asthma affects 7% of Dutch children and poses an increasing challenge, highlighting the need for effective paediatric asthma care. Achieving optimal asthma control is crucial given the potentially negative long-term effects of bad asthma control on lung development and quality of life in young children. The aim was to understand the challenges and requirements of existing asthma management practices in children. In a qualitative explorative study design, semi-structured, in-depth interviews were held among 37 Dutch stakeholders. A total of 15 patients/parents, 10 general practitioners (GPs), 5 paediatricians/paediatric pulmonologists and 7 nursing specialist/pulmonary nurses participated. Analysis was based on a thematic inductive analysis, using open and axial coding. GPs tended to emphasise the treatment of patients/parents with acute symptoms and underestimate the diagnosis and management of chronic symptoms, leading to possible over- and undertreatment. Asthma care between primary and secondary healthcare is fragmented and worsens these challenges. Moreover, the absence of well-established follow-up structures in primary care contributes to insufficient self-management skills among patients. Shared Decision-Making in children lacks a tailored approach, with variable engagement levels among healthcare providers. Limited focus on preventive strategies leads to little attention to, for example, promoting healthy lifestyles. Moreover, children are often not actively involved in decision-making. The study provides valuable insights to improve the quality and continuity of care for children with asthma and their parents. It underlines the need for a comprehensive and integrated care pathway to minimise the long-term negative effects of uncontrolled asthma.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"42"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854785","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":"\"I know this is on my chest, let's act\": a qualitative study exploring self-management of acute COPD exacerbations with a sputum colour chart to reduce unnecessary antibiotic use.","authors":"R L Adams, M McKenna, K Allsopp, S Saleem, N Le Mesurier, N Diar Bakerly, A M Turner, N K Gale","doi":"10.1038/s41533-024-00398-3","DOIUrl":"10.1038/s41533-024-00398-3","url":null,"abstract":"<p><p>Half of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are caused by bacterial infection, but self-management plans (SMPs) generally advocate use of antibiotics and steroids for all events. We report findings from a qualitative study exploring the acceptability of a sputum colour chart and SMP to guide patient use of antibiotics and steroids (commonly termed a 'rescue pack'). Qualitative interviews were conducted with healthcare professionals (HCPs) and patients from the Colour COPD trial - a randomised controlled trial of usual care (SMP alone) versus usual care plus sputum colour chart to manage AECOPD across England and sampled to promote maximum variation. Interviews were audio-recorded, transcribed clean verbatim, then analysed thematically, using an adapted Framework approach. Expert patients contributed to the patient data analysis. Fourteen HCPs and 39 patients were interviewed from primary and secondary care. Three overarching themes were identified. (1) Handling tensions: the tension between stewardship of antimicrobials and need to reduce risk of serious illness. (2) Clinical and embodied legacies: established clinical practices of infection control and patient's own experiences of managing their condition over time have focused on early intervention for AECOPD. (3) Changing self-management practices: opportunities for changing practices through negotiating change between HCP and patient. In conclusion, while, in principle, the assessment of sputum colour using a chart to manage AECOPD was acceptable to both patients and HCPs, in practice, it is unlikely to have significant impact on well-established clinical practices for infection control and patient habits of self-management.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"41"},"PeriodicalIF":3.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771125","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 and acceptability of an asthma diagnosis clinical decision support system for primary care clinicians: an observational mixed methods study.","authors":"Luke Daines, Anne Canny, Eddie Donaghy, Victoria Murray, Leo Campbell, Carol Stonham, Heather Milne, David Price, Mark Buchner, Lesley Nelson, Frances S Mair, Aziz Sheikh, Andrew Bush, Brian McKinstry, Hilary Pinnock","doi":"10.1038/s41533-024-00401-x","DOIUrl":"10.1038/s41533-024-00401-x","url":null,"abstract":"<p><p>There is uncertainty about how best to diagnose asthma, especially in primary care where mis-diagnosis is common. To address this, we developed a clinical decision support system (CDSS) for asthma diagnosis in children and young people (aged 5-25 years). This study explored the feasibility and acceptability of the CDSS in UK primary care. We recruited general practices from England and Scotland. The CDSS was available for use during routine consultations for six months. We analysed CDSS usage and, toward the end of the study, undertook qualitative interviews with clinicians who had used the CDSS. Within the 10 practices who completed the study, the CDSS was used by 75 out of 94 clinicians. 11 clinicians from 8 practices were interviewed. The CDSS was acceptable to participants who particularly commented on the ease of use and auto-population of information from the patient record. Barriers to use included the inability to record findings directly into the patient notes and a sense that, whilst possibly useful for trainees and junior colleagues, the CDSS would not necessarily lead to a change in their own practice. The CDSS was generally well received by primary care clinicians, though participants felt it would be most useful for trainees and less experienced colleagues.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"40"},"PeriodicalIF":3.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739496","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":"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/s41533-024-00399-2","DOIUrl":"10.1038/s41533-024-00399-2","url":null,"abstract":"<p><p>Primary care clinicians play a key role in asthma and asthma exacerbation management worldwide because most patients with asthma are treated in primary care settings. The high burden of asthma exacerbations persists and important practice gaps remain, despite continual advances in asthma care. Lack of primary care-specific guidance, uncontrolled asthma, incomplete assessment of exacerbation and asthma control history, and reliance on systemic corticosteroids or short-acting beta₂-agonist-only therapy are challenges clinicians face today with asthma care. Evidence supports the use of inhaled corticosteroids (ICS) + fast-acting bronchodilator treatments when used as needed in response to symptoms to improve asthma control and reduce rates of exacerbations, and the symptoms that occur leading up to an asthma exacerbation provide a window of opportunity to intervene with ICS. Incorporating patient perspectives and preferences when designing asthma regimens will help patients be more engaged in their therapy and may contribute to improved adherence and outcomes. This expert consensus contains 10 Best Practice Advice Points from a panel of primary care clinicians and a patient representative, formed in collaboration with the International Primary Care Respiratory Group (IPCRG), a clinically led charitable organization that works locally and globally in primary care to improve respiratory health. The panel met virtually and developed a series of best practice statements, which were drafted and subsequently voted on to obtain consensus. Primary care clinicians globally are encouraged to review and adapt these best practice advice points on preventing and managing asthma exacerbations to their local practice patterns to enhance asthma care within their practice.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"39"},"PeriodicalIF":3.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648329","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":"Web-based pulmonary telehabilitation: a systematic review.","authors":"Manuel Ayala-Chauvin, Fernando A Chicaiza, Patricia Acosta-Vargas, Janio Jadan, Verónica Maldonado-Garcés, Esteban Ortiz-Prado, Gloria Acosta-Vargas, Mayra Carrión-Toro, Marco Santórum, Mario Gonzalez-Rodriguez, Camila Madera, Wilmer Esparza","doi":"10.1038/s41533-024-00396-5","DOIUrl":"10.1038/s41533-024-00396-5","url":null,"abstract":"<p><p>Web-based pulmonary telerehabilitation (WBPTR) can serve as a valuable tool when access to conventional care is limited. This review assesses a series of studies that explore pulmonary telerehabilitation programmes delivered via web-based platforms. The studies involved participants with moderate to severe chronic obstructive pulmonary disease (COPD). Of the 3190 participants, 1697 engaged in WBPTR platforms, while the remaining 1493 comprised the control groups. Sixteen studies were included in the meta-analysis. Web-based pulmonary telerehabilitation led to an increase in daily step count (MD 446.66, 95% CI 96.47 to 796.86), though this did not meet the minimum clinically important difference. Additionally, WBPTR did not yield significant improvements in the six-minute walking test (MD 5.01, 95% CI - 5.19 to 15.21), health-related quality of life as measured by the St. George's Respiratory Questionnaire (MD - 0.15, 95% CI - 2.24 to 1.95), or the Chronic Respiratory Disease Questionnaire (MD 0.17, 95% CI - 0.13 to 0.46). Moreover, there was no significant improvement in dyspnoea-related health status, as assessed by the Chronic Respiratory Disease Questionnaire (MD - 0.01, 95% CI - 0.29 to 0.27) or the modified Medical Research Council Dyspnoea Scale (MD - 0.14, 95% CI - 0.43 to 0.14). Based on these findings, this review concludes that WBPTR does not offer substantial advantages over traditional care. While slight improvements in exercise performance were observed, no meaningful enhancements were noted in dyspnoea or quality of life metrics. Overall, WBPTR remains a complementary and accessible option for managing and monitoring COPD patients. However, further research and innovation are required to improve its efficacy and adapt it to various clinical environments.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"38"},"PeriodicalIF":3.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644615","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}