International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"A Brief and Effective Questionnaire for COPD Screening in High-Altitude Areas.","authors":"Jia Cui, Yuxia Wang, Yaqi Tong, Yixuan Liao, Yan Liu, Di Chai, Zhenzhen Xing, Huanyu Long, Yanfei Guo","doi":"10.2147/COPD.S505941","DOIUrl":"https://doi.org/10.2147/COPD.S505941","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a reliable screening questionnaire for chronic obstructive pulmonary disease (COPD) for primary health care institutions in high-altitude areas.</p><p><strong>Patients and methods: </strong>This was a large cross-sectional study. The study included individuals who resided at an altitude of more than 2100 meters, were aged 35 years or older. The data were randomly divided into a development set and a validation set at a ratio of 7:3. Single-factor and multifactor logistic regression equations were employed to identify pertinent variables and construct a scoring system. The receiver operating characteristic (ROC) curve, area under the curve (AUC), positive predictive value (PPV) and negative predictive value (NPV) were used to evaluate the discriminative ability of the questionnaire.</p><p><strong>Results: </strong>A total of 2909 individuals were included in this study, including 1304 males (44.83%), with a median age of 47.00 (41.00-55.00) years. A multivariate analysis of the development set revealed that five variables (age, history of pulmonary tuberculosis, smoking status, household air pollution exposure and CPOD Assessment Test (CAT) score) were significantly correlated with COPD. A scoring system was constructed on the basis of these findings. The AUC for the model in the development set was 0.714, whereas that for the validation set was 0.726. ROC analysis indicated that the optimal diagnostic cutoff value for the score was 22 points, with a sensitivity of 85.0% and a specificity of 48.4%. The results indicated that the sensitivity of the model was the highest (87.3%) at altitudes between 2100 and 3000 meters, whereas the specificity was the highest (80.9%) at altitudes >4000 meters. The conclusions were essentially consistent when the lower limit of normal (LLN) was used to verify the values in different altitude areas.</p><p><strong>Conclusion: </strong>The COPD screening questionnaire effectively screens COPD in high-altitude primary healthcare settings.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1239-1248"},"PeriodicalIF":2.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051239","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 Effects of Smoking and Airway Restriction on Subclinical Atherosclerosis.","authors":"Mihrican Yeşildağ, Zeynep Keskin, Durdu Mehmet Yavşan, Taha Tahir Bekci, Usame Omer Osmanoglu","doi":"10.2147/COPD.S512381","DOIUrl":"https://doi.org/10.2147/COPD.S512381","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a chronic disease associated with systemic inflammation that may accelerate the atherosclerotic process. Smoking is a common risk factor for COPD and atherosclerosis. The goal of this study was to investigate the effects of COPD and smoking on carotid intima-media thickness (CIMT), in order to emphasise their importance in terms of subclinical atherosclerosis.</p><p><strong>Materials and methods: </strong>The study involved 208 male patients aged 45-65 years and was designed as a prospective, observational case-control study. Patients were separated into three groups, as follows: Group 1-non-smokers without airway obstruction (control) (n= 70); Group 2-smokers without airway obstruction (n= 70); and Group 3-smokers with airway obstruction(COPD) (n= 68). They were also classified into thickened CIMT (≥0.8mm) and normal CIMT (<0.8mm) groups. Pulmonary function tests (PFT), carotid Doppler ultrasound, and biochemical and haematological tests were applied to all the participants.</p><p><strong>Results: </strong>CIMT values were markedly increased in the COPD group (1.00 [0.90-1.30] mm), compared to the smoker group without airway obstruction (0.70 [0.58-0.90] mm) and the non-smoker control group (0.60 [0.50-0.70] mm). The factors associated with CIMT were FEV₁/FVC ratio (Exp B 0.0952, p=0.003), age (Exp B 1.082, p<0.001), and cigarette pack-years (Exp B 1.030, p=0.020). In feature importance analysis, the most influential factor on CIMT was the FEV₁/FVC ratio (0.54) indicating COPD, followed by age (0.33) and cigarette pack-years (0.13).</p><p><strong>Conclusion: </strong>Among the factors influencing CIMT, the impact of a decreased FEV₁/FVC ratio was found to be the highest. Therefore, screening with carotid US should be considered for the early detection of subclinical atherosclerosis in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1217-1226"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055971","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":"Increased Stress Hyperglycemia Ratio Predicts Poor Clinical Outcome in Critically Ill COPD Patients: A Retrospective Study.","authors":"Mengyuan Qiao, Hui Yang, Mengzhen Qin, Yingyang Li, Haiyan Wang","doi":"10.2147/COPD.S520418","DOIUrl":"https://doi.org/10.2147/COPD.S520418","url":null,"abstract":"<p><strong>Objective: </strong>Stress hyperglycemia ratio (SHR) was introduced as an indicator of relative hyperglycaemia and is widely used for prognostic prediction in critically ill patients. The present study aimed to investigate the relationship between SHR and adverse clinical outcomes in critically ill COPD patients.</p><p><strong>Methods: </strong>A total of 1,580 patients diagnosed with COPD were included in this retrospective cohort study. SHR = ABG (mmol/L) / [1.59 × HbA1c (%) - 2.59]. Primary endpoints included ICU mortality and in-hospital mortality. Secondary endpoints were acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute respiratory failure (ARF). Logistic regression, Restricted Cubic Sample (RCS) and Receiver Operating Characteristic (ROC) were used to explore the relationship between SHR and prognosis of COPD patients. In addition, subgroup analyses and interaction tests were performed to investigate potential heterogeneity.</p><p><strong>Results: </strong>Multivariate logistic regression analysis showed that elevated SHR was not associated with ICU mortality and in-hospital mortality. In contrast, SHR quartiles were correlated with ICU mortality and in-hospital mortality. Restricted cubic spline regression models showed a nonlinear correlation between SHR and both ICU mortality and in-hospital mortality (all <i>P</i><0.001). In addition, a linear correlation was found between SHR and AECOPD and ARF, with elevated SHR associated with increased risk of AECOPD and ARF. <i>ROC</i> analyses showed that SHR was a more effective predictor of mortality and prognosis than admission blood glucose (ABG) and hemoglobin A1c (HbA1c) in patients with COPD, with the former being a better predictor of mortality and prognosis. In subgroup analyses, after adjusting for all covariates considered in the present study, the relationship between SHR and prognostic risk in patients with COPD remained stable across gender, age, BMI, smoking, drinking, history of hypertension, coronary heart disease, diabetes, and cerebrovascular disease.</p><p><strong>Conclusion: </strong>SHR is independently associated with an increased risk of adverse clinical outcomes in critically ill COPD patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1203-1215"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055220","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":"Treatable Traits in Patients with Obstructive Lung Diseases in a Well-Established Asthma/COPD Service for Primary Care.","authors":"Lars Dijk, Yoran H Gerritsma, Thys Van der Molen, Ian Pavord, Ronald J Meijer, Huib Kerstjens, Janwillem Kocks","doi":"10.2147/COPD.S508281","DOIUrl":"https://doi.org/10.2147/COPD.S508281","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective of this study was to assess the prevalence of treatable traits (TTs) in patients with obstructive lung diseases in a primary care setting and how these TTs co-occur. The secondary objective was to assess the stability of TTs and the effect of management advice on changes in traits and health outcomes.</p><p><strong>Patients and methods: </strong>Data from the Dutch asthma/COPD service (2007-2023) were studied retrospectively. Patients ≥18 years with asthma, COPD, or Asthma-COPD overlap (ACO) were included. The prevalence of eight TTs were assessed: 1) insufficient inhaler technique, 2) poor medication adherence, 3) blood eosinophilia, 4) smoking, 5) obesity, 6) physical inactivity, 7) reversible airflow limitation, and 8) anxiety and/or depression. The effect of management advice on TTs was evaluated for patients with a follow-up visit scheduled within 1-2 years.</p><p><strong>Results: </strong>In total, 15246 patients (COPD n=4822; ACO n=1761, asthma n=8663) were included. The highest proportions of TTs were insufficient inhaler technique: 43.6% (95% CI: 42.9-44.4), followed by poor medication adherence: 40.3% (95% CI: 39.2-41.4) and blood eosinophilia: 36.9% (95% CI: 35.8-38.1). Overall, 83.3% of patients had ≥ 1 TTs, and 48.9% of patients ≥ 2 TTs. Among patients with blood eosinophilia, a significant reduction of the trait at follow-up (OR: 0.61, 95% CI: 0.39; 0.96) and improved health status were observed when the pulmonologist advised the general practitioner to initiate or increase the dose of ICS. No significant association was found between management advice and the exacerbation rate at follow-up.</p><p><strong>Conclusion: </strong>The TTs assessed in this study are common in primary care patients, with nearly half of the patients showing a combination of at least two TTs. These TTs coexist in many different combinations. A personalized approach targeting these traits may be effective in achieving better control of these heterogeneous diseases.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1189-1201"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051267","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":"Association Between Physical Activity, Sedentary Behavior and Sleep Disorders in Chronic Obstructive Pulmonary Disease Patients: A Cross-Sectional Study.","authors":"Xianghui Ma, Qing Zhang, Xigang Gao, Mingxiang Sun","doi":"10.2147/COPD.S487616","DOIUrl":"https://doi.org/10.2147/COPD.S487616","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disorder is a common comorbidity in chronic obstructive pulmonary disease (COPD). We aim to explore the potential association between daily sitting time (DST), leisure-time physical activity (LTPA) and sleep disorders in COPD patients.</p><p><strong>Methods: </strong>The sleep, LTPA, and DST data of participants with COPD were extracted from the National Health and Nutrition Examination Survey (NHANES) portal (2007-2012), basing on Global Physical Activity Questionnaire. The <i>t</i>-test, Mann-Whitney test, or chi-square test were employed to analyze the differences between two groups. The weighted binomial logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of DST and LTPA on sleep disorders. The analyses were conducted from April 1 to July 1, 2023.</p><p><strong>Results: </strong>A total of 2063 COPD samples were included in this work, of which 58% had LTPA < 150 min/wk and 48% had DST > 6h. Patients with sleep disorders had longer sedentary time (DST > 6h: 151, DST > 8h: 105) and less physical activity (LTPA < 150min/wk: 185). Longer sedentary time was correlated with a higher risk of sleep disorders, while LTPA showed no significant correlation with sleep disorders. The conjoint analysis revealed that the risk of sleep disorders in patients with LTPA <150 min/wk and DST > 8h was 5.88 times (95% CI: 1.80-19.2) great than that of patients with LTPA≥150 min/wk and DST < 4h.</p><p><strong>Conclusion: </strong>COPD patients often lacked physical activity and exhibited sedentary behaviors. Long-term sedentary behavior was associated with elevated risk of sleep disorders in COPD patients. More light intensity physical activity and supervised exercise programs are probably good choices to prevent sleep disorders in COPD population.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1175-1187"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005056","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":"Plasma Levels of CXCL9 and MCP-3 are Increased in Asthma-COPD Overlap (ACO) Patients.","authors":"Jose Miguel Escamilla-Gil, Carlos A Torres-Duque, Kevin Llinás-Caballero, Nadia Juliana Proaños-Jurado, María M De Vivero, Jonathan Camilo Ramirez, Ronald Regino, Lucila Teresa Florez de Arco, Rodolfo Dennis, Mauricio González-García, Luis Caraballo, Nathalie Acevedo","doi":"10.2147/COPD.S506517","DOIUrl":"10.2147/COPD.S506517","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma and chronic obstructive pulmonary disease overlap patients (ACO) have more exacerbations and a worse prognosis than pure asthma or COPD, and it is of great interest to identify differential biomarkers of ACO. We compared blood eosinophil counts, plasma IgE and protein levels among patients with asthma, ACO, COPD, and healthy subjects to identify those associated with ACO.</p><p><strong>Patients and methods: </strong>397 adults (age 40-90 years) were recruited from two Colombian cities: asthma (n=123), COPD (n=100), ACO (n=74) and healthy control (HC, n=100). Plasma protein levels were measured using the Proximity Extension Assay (Olink Proteomics).</p><p><strong>Results: </strong>There were no differences in blood eosinophil counts between the patient groups. Total and specified IgE levels were higher in patients with ACO than in those with COPD. Ten plasma proteins showed significant differences between the patients with ACO and HC. In patients above 60 years old, CXCL9 discriminates ACO from asthma patients with AUC 0.73 (0.63-0.82, DeLong test p=0.007), and in patients below 60 years old, MCP-3 discriminates ACO from COPD patients with AUC 0.84 (0.62-1.0, DeLong test p=0.006). CUB domain-containing protein 1 (CDCP1) levels (OR, 0.47; p=0.008) and age > 60 years (OR, 0.25; p=0.001) were negatively associated with ACO.</p><p><strong>Conclusion: </strong>CXCL9 levels could be used to discriminate ACO from asthma patients and MCP-3 to discriminate ACO from COPD. Protein inflammatory signatures in plasma of ACO patients were similar to the COPD group. This study revealed novel biomarkers that may help characterize patients with ACO.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1161-1174"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062915","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":"Optimizing Treatment for Hospitalized Patients with COPD: A Study on the Impact of a LINE App-Based Multidisciplinary Team Approach Targeting Pharmacological Treatment, Lifestyle Changes, and Smoking Cessation.","authors":"Hsiang-Yu Huang, Chia-Ling Chen, Yi-Ling Lin, Shu-Chuan Chen, Li-Chu Lee, Huei-Min Dai, Cheng-Yang Chiang, Yu-Fan Chang, Hsiu Lu, Mung-Rung Lee, Chih-Chiao Yang, Chiu-Hui Su, Ying-Zhen Chiang, Mei-Chen Yang, Rong-Yaun Shyu, Chou-Chin Lan","doi":"10.2147/COPD.S511869","DOIUrl":"https://doi.org/10.2147/COPD.S511869","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition that significantly impacts patients' health status. Effective management requires a multidisciplinary team (MDT) to address pharmacological and non- pharmacological treatments. The integration of mobile apps and devices improves COPD management by reducing symptoms and exacerbations. LINE, a commonly used communication app, enhanced team coordination and real-time decision-making. This study explored the effectiveness of LINE-based MDT interventions in hospitalized patients with COPD.</p><p><strong>Methods: </strong>This retrospective analysis included patients with COPD admitted for exacerbations and compared their outcomes before and after the implementation of LINE-based MDT care. The MDT consisted of pulmonologists, care managers, nurses, dietitians, social workers, pharmacists, respiratory therapists, and long-term care teams. A LINE group coordinated care in real-time, enabling the team to promptly review the patients' conditions, adjust treatment plans, and provide tailored interventions.</p><p><strong>Results: </strong>The LINE-based MDT group demonstrated significantly higher intervention rates, including systemic steroids, inhaled corticosteroids, long-acting beta-agonists, long-acting muscarinic antagonists, and pulmonary rehabilitation (p<0.05). BSRS improvement was greater in the MDT group than the non-MDT group (40.9% vs 29.7%, p = 0.016). However, there were no significant differences between the groups' readmission rates, emergency room visits, or one year survival (p>0.05).</p><p><strong>Conclusion: </strong>Implementing LINE-based MDT care significantly improved the delivery of pharmacological and non-pharmacological interventions, enhanced coordination, and facilitated comprehensive management, leading to better quality of life outcomes, as evidenced by improvements in BSRS scores. This highlights the value of leveraging real-time communication tools like LINE app to optimize COPD care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1149-1159"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004206","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 Case of Tracheal Stenosis Following Brief Intubation for an Acute Exacerbation of COPD.","authors":"Ju-Zhang Li, Qing Feng, Yu-Feng Liu, Jiang-Nan Zheng","doi":"10.2147/COPD.S503495","DOIUrl":"https://doi.org/10.2147/COPD.S503495","url":null,"abstract":"<p><p>Tracheal stenosis following brief intubation is a rare but serious complication and could be misdiagnosed in specific individuals, especially those with chronic obstructive pulmonary disease (COPD) and asthma. This case report describes a patient with COPD who developed tracheal stenosis following emergency intubation for an acute exacerbation. The patient was managed with invasive ventilation for 28 hours due to an acute exacerbation of COPD and pulmonary encephalopathy. After extubation, the patient presented with respiratory distress, which was successfully treated with bronchoscopic cryotherapy.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1143-1147"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055219","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":"Characteristics of Patients Initiated on Budesonide/Glycopyrronium Bromide/Formoterol Fumarate Single Inhaler Triple Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Population-Based Observational Study.","authors":"Gaétan Deslee, Caroline Fabry-Vendrand, Elsa Salmi, Nolwenn Poccardi, Adrien Coriat, Idir Ghout, Caroline Eteve-Pitsaer, Nicola J Adderley, Henri Leleu","doi":"10.2147/COPD.S495086","DOIUrl":"https://doi.org/10.2147/COPD.S495086","url":null,"abstract":"<p><strong>Background: </strong>Budesonide/glycopyrronium bromide/formoterol fumarate (BUD/GLY/FOR) single inhaler triple therapy became available to prescribe to patients with severe chronic obstructive pulmonary disease (COPD) in France in 2021. The characteristics of patients prescribed BUD/GLY/FOR triple therapy and guideline adherence have not been previously described in France.</p><p><strong>Objective: </strong>To describe the characteristics of COPD patients initiated on BUD/GLY/FOR triple therapy, assess adherence to COPD management guidelines, and explore any differences by prescribing physician.</p><p><strong>Materials and methods: </strong>A cross-sectional study using data from The Health Improvement Network (THIN^®) France database was conducted. Patients with ≥2 recorded diagnostic codes for COPD were included. Demographic characteristics, comorbidities, management, COPD-related characteristics, and guideline adherence (Société de Pneumologie de Langue Française (SPLF); Haute Autorité de Santé (HAS)), stratified by initiating physician speciality (general practitioner (GP) or pulmonologist) were described.</p><p><strong>Results: </strong>A total of 263 patients initiating BUD/GLY/FOR triple therapy were included. Mean (SD) age was 68.8 (11.8) years; 53.6% were male. Mean (SD) COPD duration was 6.4 (5.5) years. Comorbidities were common, with slightly more cardiometabolic and mental health conditions recorded in the GP-initiated group, and more comorbid respiratory conditions recorded in the pulmonologist-initiated group. About 77.2% (n=203) of patients had at least one moderate or severe exacerbation in the 12 months before initiation. About 86.3% had a previous record of dual (n=117, 44.5%) or triple (n=110, 41.8%) therapy. About 68.8% had been initiated on BUD/GLY/FOR triple therapy in line with SPLF guidelines (62.4% and 72.4% in the GP- and pulmonologist-initiated groups, respectively); among those with a record of COPD severity, 75.2% were initiated in line with HAS guidelines (69.2% and 76.3% in the GP- and pulmonologist-initiated groups, respectively).</p><p><strong>Conclusion: </strong>The majority of COPD patients are prescribed BUD/GLY/FOR triple therapy in accordance with current treatment guidelines, irrespective of whether the therapy is prescribed by a general practitioner or a pulmonologist.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1131-1142"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023591","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":"Impact of a Heating Voucher on Health Outcomes in COPD Patients: A Randomised Controlled Trial.","authors":"Helen Elizabeth Viggers, Tristram Richard Ingham, Ralph Brougham Chapman, Julian Crane, Ann Beatrice Currie, Cheryl Davies, Michael Keall, Philippa Lynne Howden-Chapman","doi":"10.2147/COPD.S483194","DOIUrl":"https://doi.org/10.2147/COPD.S483194","url":null,"abstract":"<p><strong>Purpose: </strong>Aotearoa New Zealand (NZ) homes are cold by international standards, with many failing to achieve temperatures recommended by WHO housing and health guidelines. Despite strong evidence of seasonal exacerbations in Chronic Obstructive Pulmonary Disease (COPD), there has been little examination of the effect of household warmth, or housing quality on COPD outcomes. The Warm Homes for Elder New Zealanders (WHEZ) study aimed to see if subsidising electricity costs would improve the health outcomes of older people with COPD. Previous analysis showed a modest, typically 2-10% dependent on prior usage, increase in electricity use among the subsidised households.</p><p><strong>Patients and methods: </strong>Participants aged over 55 with doctor-diagnosed COPD were recruited from three regional centres, and where possible their dwelling was insulated after enrolment. A single-blinded randomised controlled trial of the effect of an electricity voucher (NZ$500) on health care usage during winter was carried out in three locations across New Zealand. The primary outcome was exacerbations treated with antibiotics, and/or corticosteroids. The Clinical Trial Registration is NCT01627418. Of the 520 participants assigned to a wave, partial or better data was achieved for 424; 215 of those were randomised to the early intervention group, and 209 to receive the intervention later.</p><p><strong>Results: </strong>Despite the modest increase in energy use by study households, reported previously, there was no significant difference between study arms in the frequency of exacerbation of COPD (0.089, p=0.5875, 95% CI -1.406-1.584) nor hospitalisations. An exploratory analysis suggested a lower mortality among participants assigned to receive the intervention first (OR 0.310, p=0.0175, 95% CI 0.118-0.815).</p><p><strong>Conclusion: </strong>This study showed little effect of winter electricity vouchers on exacerbations of COPD. However, such vouchers increased energy use and may have reduced overall mortality. A larger study, particularly with susceptible subpopulations, is recommended to examine this mortality impact further.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1097-1109"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021829","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}