General practice and primary care最新文献_第9页

Frequency of occurrence of risk factors of cardiovascular diseases and assessment of the total cardiovascular risk in patients with chronic obstructive pulmonary disease (COPD) 慢性阻塞性肺疾病(COPD)患者心血管疾病危险因素发生频率及心血管总危险评估

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5021

K. Klester, E. Klester, A. Zharikov, A. Balitskaya, A. Denisova

{"title":"Frequency of occurrence of risk factors of cardiovascular diseases and assessment of the total cardiovascular risk in patients with chronic obstructive pulmonary disease (COPD)","authors":"K. Klester, E. Klester, A. Zharikov, A. Balitskaya, A. Denisova","doi":"10.1183/13993003.congress-2019.pa5021","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5021","url":null,"abstract":"Introduction: Cardiovascular diseases are diagnosed in more than half of patients and aggravate the course of COPD. Objective: To assess the frequency of risk factors of cardiovascular disease and the degree of total cardiovascular risk in patients with COPD. Materials and Methods: 518 patients were under supervision, 122 of them (with mild and moderate СOPD (GOLD, 2018) were included in the final analysis, satisfying the inclusion criteria: the absence of clinical manifestations of cardiovascular disease, MI and stroke history, DM. The European SCORE scale was used to assess coronary risk. Results: Low total cardiovascular risk was diagnosed in 15 (12%), medium – in 29 (24%), high – in 41 (34%), very high risk by SCORE – in 37 (30%) COPD patients. A regression analysis revealed correlation between the risk of COPD exacerbations (mMRC or CAT, severity according to spirometry) and the total cardiovascular risk of SCORE (r = 0.58; p = 0.001), as well as between the comorbidity index by M. Charlson et al. (1987) and risk by SCORE (r = 0.61; p = 0.006). The relationship between BMI and cholesterol in the study was J-shaped. The effect of inhalation therapy on the occurrence of the first manifestation of CVD was not established by Cox regression. Conclusion: in 75% of patients with COPD, an increased 10-year risk of all fatal complications of atherosclerosis is determined. The study indicates the need to assess the risk by SCORE in patients with initial manifestations of COPD in order to timely correction of the identified risk factors for cardiovascular disease.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116015423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Measuring guideline adherence for the diagnosis and management of common cold and pneumonia in rural Gambia. A case for a Clinical Decision Support System in rural sub-Sarahan Africa? 衡量冈比亚农村普通感冒和肺炎诊断和管理的指南依从性临床决策支持系统在撒哈拉以南非洲农村的案例?

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa727

F. Mosler, S. Unger

引用次数: 1

Asthma patients’ views and experiences of self-management in Malaysia: a qualitative study 马来西亚哮喘患者自我管理的观点与经验:一项质性研究

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3993

Wenjun Koh, E. Khoo, A. I. A. Bakar, N. Hussein, H. Pinnock, S. Liew, N. Hanafi, Y. Pang, B. K. Ho, Mohamed Isa Salbiah

引用次数: 0

Corerelation of COPD exacerbation with comorbidities, Lung function and mortality within a single-practice primary-care cohort in the UK COPD加重与合并症、肺功能和死亡率的相关性在英国单一实践初级保健队列中

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5010

Mukesh Singh, Ketan Singh

{"title":"Corerelation of COPD exacerbation with comorbidities, Lung function and mortality within a single-practice primary-care cohort in the UK","authors":"Mukesh Singh, Ketan Singh","doi":"10.1183/13993003.congress-2019.pa5010","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5010","url":null,"abstract":"Introduction and Objectives: COPD as being a heterogeneous disease, its patients show variation in disease severity, burden of comorbidity and their need for unscheduled clinical consultations. The aim of this retrospective study was to evaluate patterns in clinical care and COPD related ‘events’ across a single-year in a UK single-practice primary-care cohort. Methods: The clinical record system of practice population of 11474 patients was searched to identify all registered patients with COPD with data available for the period April17–March18. All cases were reviewed including disease duration, account of exacerbations with their treatment, related hospitalizations and mortality, co-morbidities and changes in FEV1. Results: Out of total 331 COPD patients; most had long-standing disease approx 10 years, although this varied widely. Mean % FEV1 was 60.4% (range 14–118%) with 71% with dyspnoea of MRC 2 or 3. 95% of them had at least one co-morbidity, mainly diabetes/arthritis or cardiovascular disease. There was no exacerbation in 137 patients (41.4%). Of patients with at least one event, 111 (33.5%) required treatment with antibiotics + oral steroids and 28 of these patients (8.5%) showed decline in FEV1. 22 patients required emergency COPD-related hospitalisations with 5 in-hospital deaths. The mean FEV1 in those patients without an exacerbation was higher compared to those with an exacerbation (66.6% vs 55.9%) and a further decline was noted in those with hospital admission history (45.8%). Conclusions: A substantial variation was observed in COPD disease burden and healthcare resource usage within the 12 months across a primary-care cohort in UK.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122015833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Assessing treatment fidelity of lay health worker support to increase uptake and completion of pulmonary rehabilitation in COPD 评估非专业卫生工作者支持的治疗保真度，以增加COPD患者肺部康复的吸收和完成

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa726

V. McMillan, G. Gilworth, A. Wright, P. White

引用次数: 0

Effect of non-pharmacological interventions on treatment outcomes in COPD patients: Little changes for bigger rewards 非药物干预对COPD患者治疗结果的影响:小变化大回报

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa722

Mrityunjaya Singh, G. N. Srivastava, D. Yadav

引用次数: 1

Development and implementation of an awareness programme addressing household air pollution and tobacco smoke: a FRESH AIR project 制定和实施解决家庭空气污染和烟草烟雾问题的认识规划:一个新鲜空气项目

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa728

F. V. Gemert, E. Brakema, R. V. D. Kleij, Siân Williams, Rupert C Jones, B. Kirenga, Shamim Buteme, T. Sooronbaev, Aizhamal K. Tabyshova, M. Mademilov, Thong An Pham Le, null Quynh Nguyen Nhat, C. Jong

引用次数: 2

Development of spirometry predictive values for Western Indian population (NIHR-RESPIRE Study) 西印度人口肺活量测定预测值的发展(NIHR-RESPIRE研究)

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa701

D. Agarwal, R. Parker, Sudipto Roy, H. Pinnock, D. Ghorpade, S. Salvi, P. Khatavkar, S. Juvekar

引用次数: 0

The VENTO study: pneumologists evaluate the practicability of German programmes for COPD patients VENTO研究:肺病学家评估德国COPD患者方案的实用性

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa714

C. Criée, Juliane Sünwoldt, Anja Selig

引用次数: 0

Development of the Birmingham Lung Improvement Studies (BLISS) prognostic score for COPD patients in primary care: data from the Birmingham COPD cohort 伯明翰肺改善研究(BLISS) COPD患者初级保健预后评分的发展:来自伯明翰COPD队列的数据

General practice and primary care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa257

R. Jordan, D. Fitzmaurice, James Martin, J. Ayres, K. Cheng, B. Cooper, A. Daley, A. Dickens, A. Enocson, S. Greenfield, Martin R Miller, R. Riley, S. Siebert, R. Stockley, A. Turner, P. Adab

{"title":"Development of the Birmingham Lung Improvement Studies (BLISS) prognostic score for COPD patients in primary care: data from the Birmingham COPD cohort","authors":"R. Jordan, D. Fitzmaurice, James Martin, J. Ayres, K. Cheng, B. Cooper, A. Daley, A. Dickens, A. Enocson, S. Greenfield, Martin R Miller, R. Riley, S. Siebert, R. Stockley, A. Turner, P. Adab","doi":"10.1183/13993003.congress-2019.oa257","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa257","url":null,"abstract":"Prognostic scores could be used to guide management of COPD patients and reduce risk of hospital admission but existing scores do not perform well enough and are not practical for primary care. Using data from the Birmingham primary care COPD cohort we developed and internally validated the new BLISS prognostic score from 23 candidate variables. 1558 patients on COPD registers of 71 GP practices and 331 newly-identified patients from a linked case-finding trial were included and their self-reported and clinical data were combined with routine hospital episode statistics. Primary outcome was the record of at least one respiratory admission within 2 years of cohort entry. The model was developed using backward elimination. Missing data were imputed using chained equations. Discrimination and calibration were assessed. Bootstrapping was used for internal validation. Median (min, max) follow up was 2.9 years (1.8, 3.8). 6 variables were retained in the final model: age, CAT score, respiratory admissions previous 12m, BMI, diabetes, FEV1% predicted. After adjustment for optimism, the model performed well in predicting 2yr respiratory admissions (c statistic=0.75 (95%CI 0.72, 0.79). The BLISS score showed better performance in predicting respiratory admissions than existing published scores. All 6 variables are readily available in primary care records or would be easy to collect, and a simple computer programme could calculate the score. Important next steps are external validation, proposing/evaluating a model of use to guide patient management and exploration of the best ways to implement the score in primary care practice.","PeriodicalId":432006,"journal":{"name":"General practice and primary care","volume":"112 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131830645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1