NPJ Primary Care Respiratory Medicine最新文献

{"title":"Documentation of comorbidities, lifestyle factors, and asthma management during primary care scheduled asthma contacts.","authors":"Jaana Takala, Iida Vähätalo, Leena E Tuomisto, Onni Niemelä, Pinja Ilmarinen, Hannu Kankaanranta","doi":"10.1038/s41533-024-00360-3","DOIUrl":"10.1038/s41533-024-00360-3","url":null,"abstract":"<p><p>Systematically assessing asthma during follow-up contacts is important to accomplish comprehensive treatment. No previous long-term studies exist on how comorbidities, lifestyle factors, and asthma management details are documented in scheduled asthma contacts in primary health care (PHC). We showed comorbidities and lifestyle factors were poorly documented in PHC in this real-life, 12-year, follow-up study. Documented information on rhinitis was found in 8.9% and BMI, overweight, or obesity in ≤1.5% of the 542 scheduled asthma contacts. Of the 145 patients with scheduled asthma contacts, 6.9% had undergone revision of their inhalation technique; 16.6% had documentation of their asthma action plan. Screening of respiratory symptoms was recorded in 79% but nasal symptoms in only 15.5% of contacts. Lifestyle guidance interventions were found in <1% of contacts. These results, based on documented patient data, indicate a need exists to further improve the assessment and guidance of asthma patients in PHC.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"2"},"PeriodicalIF":3.1,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068646","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":"Medication adherence halves COPD patients' hospitalization risk - evidence from Swiss health insurance data.","authors":"Anja Y Bischof, Johannes Cordier, Justus Vogel, Alexander Geissler","doi":"10.1038/s41533-024-00361-2","DOIUrl":"10.1038/s41533-024-00361-2","url":null,"abstract":"<p><p>Medication adherence is vital for patients suffering from Chronic Obstructive Pulmonary Disease (COPD) to mitigate long-term consequences. The impact of poor medication adherence on inferior outcomes like exacerbations leading to hospital admissions is yet to be studied using real-world data. Using Swiss claims data from 2015-2020, we group patients into five categories according to their medication possession ratio. By employing a logistic regression, we quantify each category's average treatment effect of the medication possession ratio on hospitalized exacerbations. 13,557 COPD patients are included in the analysis. Patients with high medication adherence (daily medication reserve of 80% to 100%) are 51% less likely to incur exacerbation following a hospital stay than patients with the lowest medication adherence (daily medication reserve of 0% to 20%). The study shows that medication adherence varies strongly among Swiss COPD patients. Furthermore, high medication adherence immensely decreases the risk of hospitalized exacerbations.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"34 1","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10920735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060059","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":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski","doi":"10.1038/s41533-023-00358-3","DOIUrl":"10.1038/s41533-023-00358-3","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"37"},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470557","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":"Innovation workshop using design thinking framework and involving stakeholders to co-create ideas for management of asthma.","authors":"Mabel Qi He Leow, Aminath Shiwaza Moosa, Hani Salim, Adina Abdullah, Yew Kong Lee, Chirk Jenn Ng, Ngiap Chuan Tan","doi":"10.1038/s41533-023-00357-4","DOIUrl":"10.1038/s41533-023-00357-4","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"36"},"PeriodicalIF":3.1,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71484519","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":"Implementing psychological interventions delivered by respiratory professionals for people with COPD. A stakeholder interview study.","authors":"V Wileman, V Rowland, M Kelly, L Steed, R Sohanpal, H Pinnock, S J C Taylor","doi":"10.1038/s41533-023-00353-8","DOIUrl":"10.1038/s41533-023-00353-8","url":null,"abstract":"<p><p>Implementing psychological interventions in healthcare services requires an understanding of the organisational context. We conducted an interview study with UK National Health Service stakeholders to understand the barriers and facilitators for implementing psychological interventions for people with chronic obstructive pulmonary disorder (COPD). We used TANDEM as an exemplar intervention; a psychological intervention recently evaluated in a randomised controlled trial. Twenty participants providing care and/or services to people with COPD were purposively sampled from NHS primary/secondary care, and commissioning organisations. Participants were recruited via professional networks and referrals. Verbatim transcripts of semi-structured interviews were analysed using thematic analysis. Four themes were identified: (1) Living with COPD and emotional distress affects engagement with physical and psychological services; (2) Resource limitations affects service provision in COPD; (3) Provision of integrated care is important for patient well-being; and (4) Healthcare communication can be an enabler or a barrier to patient engagement. People need support with physical and psychological symptoms inherent with COPD and healthcare should be provided holistically. Respiratory healthcare professionals are considered able to provide psychologically informed approaches, but resources must be available for training, staff supervision and service integration. Communication between professionals is vital for clear understanding of an intervention's aims and content, to facilitate referrals and uptake. There was widespread commitment to integrating psychological and physical care, and support of respiratory healthcare professionals' role in delivering psychological interventions but significant barriers to implementation due to concerns around resources and cost efficiency. The current study informs future intervention development and implementation.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"35"},"PeriodicalIF":3.1,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162389","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 inertia in asthma.","authors":"Yosuke Fukuda, Tetsuya Homma, Hironori Sagara","doi":"10.1038/s41533-023-00356-5","DOIUrl":"10.1038/s41533-023-00356-5","url":null,"abstract":"<p><p>Despite advances in pharmaceutical treatment in recent years, a relatively high proportion of patients with asthma do not have adequate asthma control, causing chronic disability, poor quality of life, and multiple emergency department visits and hospitalizations. A multifaceted approach is needed to overcome the problems with managing asthma, and clinical inertia (CI) is a crucial concept to assist with this approach. It divides clinical inertia into three main categories, which include healthcare provider-related, patient-related, and healthcare system-related CI. The strategies to overcome these CI are complex, and the M-GAP approach, which combines a multidisciplinary approach, dissemination of guidelines, utilization of applications, and development and promotion of low-cost prescriptions, will help clinicians.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"34"},"PeriodicalIF":3.1,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41207422","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 Primary Healthcare Education through lessons from a flock of birds.","authors":"Ioanna Tsiligianni, Antonios Christodoulakis, Siân Williams","doi":"10.1038/s41533-023-00355-6","DOIUrl":"10.1038/s41533-023-00355-6","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"32"},"PeriodicalIF":3.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129428","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":"Spirometry practice by French general practitioners between 2010 and 2018 in adults aged 40 to 75 years.","authors":"A Chapron, T Lemée, G Pau, S Jouneau, S Kerbrat, F Balusson, E Oger","doi":"10.1038/s41533-023-00352-9","DOIUrl":"10.1038/s41533-023-00352-9","url":null,"abstract":"<p><p>In France, most spirometries are performed by pneumologists. Spirometry is difficult to access due to the distance to medical office and long delays for appointments. This lack of accessibility contributes to the underdiagnosis of chronic obstructive pulmonary disease (COPD) among patients aged between 40 and 75 years. In recent years, general practitioners (GPs) have been performing spirometry in private practice. However, the extent of this practice is unknown. A French retrospective, repetitive transversal study analysed data from the \"Système National des Données de Santé\" (SNDS) database. The targeted population was GPs in primary care that performed spirometries between 2010 and 2018, in patients aged between 40 and 75 years. Between 2010 and 2018, 302,674 (7.2%) spirometries were performed in France by GPs in private practices, in patients 40 to 75 years old. 5.4% by \"expert GPs\" (>60 spirometries/year) and 1.8% by \"non-expert GPs\". In \"non-expert GPs\" (2.8% of French GPs in 2018), the annual number of spirometries increased by 701 each year (p < 2.10⁴), the annual number of GPs performing spirometries increased by 114 each year (p < 2.10^-5). Overall, 24.9% of the spirometries performed by GPs were referrals from other GPs. The number of spirometries performed by GPs and the number of GPs performing spirometries has gradually increased over time. However, this increase is inadequate considering the need to early detect and follow up respiratory disorders.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"33"},"PeriodicalIF":3.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147367","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 cross-country qualitative analysis of teachers' perceptions of asthma care in sub-Saharan Africa.","authors":"Kimesh Loganathan Naidoo, Sindisiwa Dladla, Reratilwe Ephenia Mphahlele, Gioia Mosler, Sophie Muyemayema, Andrew Sentoogo Ssemata, Elizabeth Mkutumula, Olayinka Olufunke Adeyeye, Olayinka Goodman, Yetunde Kuyinu, Rebecca Nantanda, Emmanuel Addo-Yobo, Sandra Kwarteng Owusu, Bernhard Arhin, Ismail Ticklay, Hilda Angela Mujuru, Jonathan Grigg, Refiloe Masekela","doi":"10.1038/s41533-023-00354-7","DOIUrl":"10.1038/s41533-023-00354-7","url":null,"abstract":"<p><p>Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers' perceptions of asthma care across six African countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"31"},"PeriodicalIF":3.1,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10517916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41138939","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":"Interaction of BMI and respiratory status in obstructive sleep apnea, a cross-sectional COPD study.","authors":"Mizuha Haraguchi Hashiguchi, Shotaro Chubachi, Wakako Yamasawa, Kengo Otsuka, Naoko Harada, Naoki Miyao, Hidetoshi Nakamura, Koichiro Asano, Kazuhiro Yamaguchi, Koichi Fukunaga","doi":"10.1038/s41533-023-00351-w","DOIUrl":"10.1038/s41533-023-00351-w","url":null,"abstract":"<p><p>This cross-sectional study of 136 patients with chronic obstructive pulmonary disease (COPD) investigated the mechanism underlying overlap syndrome, defined as coexisting COPD and obstructive sleep apnea (OSA). OSA was defined as a respiratory event index (REI) ≥ 5 events/h, determined using type-3 portable monitors. The mean REI was 12.8 events/h. Most participants (60.1%) had mild OSA (REI: 5-15 events/h). The REI was positively correlated with forced expiratory volume in one second (%FEV₁) (r = 0.33, p < 0.001), body mass index (BMI) (r = 0.24, p = 0.005), and fat-free mass index (r = 0.31, p = 0.005), and negatively correlated with residual volume divided by total lung capacity (r = -0.27, p = 0.003). Receiver-operating characteristic curve analysis revealed an optimal BMI cutoff of 21.96 kg/m² for predicting moderate/severe OSA. A BMI ≥ 21.96 kg/m² was associated with OSA among participants with %FEV₁ ≥ 50%, but not those with %FEV₁ < 50%. This study revealed an interaction between airflow limitation and hyperinflation, nutritional status, and OSA.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"30"},"PeriodicalIF":3.1,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10394559","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}