Primary Care Respiratory Journal最新文献

{"title":"Validation of the COPD Diagnostic Questionnaire in an Australian general practice cohort: a cross-sectional study.","authors":"Anthony J Stanley, Iqbal Hasan, Alan J Crockett, Onno C P van Schayck, Nicholas A Zwar","doi":"10.4104/pcrj.2014.00015","DOIUrl":"10.4104/pcrj.2014.00015","url":null,"abstract":"<p><strong>Background: </strong>The gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD) is spirometry, but there are barriers to its use in primary care.</p><p><strong>Aims: </strong>To externally validate the COPD Diagnostic Questionnaire (CDQ) as a diagnostic tool in patients at increased risk in Australian general practice and to compare its performance with other CDQ validation studies.</p><p><strong>Methods: </strong>Patients were recruited from 36 general practices in Sydney, Australia. Former or current smokers aged 40-85 years with no prior COPD diagnosis were invited to a case-finding appointment with the practice nurse. The CDQ was collected and pre- and postbronchodilator spirometry was performed. Cases for whom complete CDQ data were present and the spirometry met quality standards were analysed.</p><p><strong>Results: </strong>Of 1,631 patients who attended case-finding recruitment, 1,054 (65%) could be analysed. Spirometry showed 13% had COPD. The ability of the CDQ to discriminate between patients with and without COPD was fair, represented by the area under the receiver operating characteristic curve of 0.713. With a CDQ cut-off point value of 16.5 the sensitivity was 80% and specificity 47% and, at a cut-off point value of 19.5, the sensitivity was 63% and specificity 70%.</p><p><strong>Conclusions: </strong>The CDQ did not discriminate between patients with and without COPD accurately enough to use as a diagnostic tool in patients at increased risk of COPD in Australian general practice. Further research is needed on the value of the CDQ as a tool for selecting patients for spirometry.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"92-7"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32155509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A golden goal in 2010, and another GOLD in 2014 in primary care, or vice versa.","authors":"Joan B Soriano,&nbsp;Miguel Román Rodríguez","doi":"10.4104/pcrj.2014.00018","DOIUrl":"10.4104/pcrj.2014.00018","url":null,"abstract":"References 1. Steppuhn H, Langen U, Keil T, Scheidt-Nave C. Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update (GEDA) 2009 and 2010. Prim Care Respir J 2014;23(1):22-29. http://dx.doi.org/10.4104/pcrj.2013.00107 2. Commission on Social Determinants of Health, Closing the gap in a generation. Health equity through action on the social determinants of health. 2008, World Health Organisation: Geneva. 3. van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity: what's in a name? A review of literature. Eur J Gen Pract 1996;2:65-70. http://dx.doi.org/10.3109/13814789609162146 4. Barnett, K., S. Mercer, et al. Epidemiology of multimorbidity and implications for health care, research, and medical edication: a cross-sectional study. Lancet 2012;380(9836):37-43. http://dx.doi.org/10.1016/S0140-6736(12)60240-2 5. Guthrie B, Payne K, Alderson P, McMurdo MET, Mercer SW. Adapting clinical guidelines to take account of multimorbidity. BMJ 2012;345:e6341. http://dx.doi.org/10.1136/bmj.e6341 6. Payne RA, Abel GA, Avery AJ, Mercer SW, Roland MO. Is polypharmacy always hazardous? A retrospective cohort analysis using linked electronic health records from primary and secondary care. Br J Clin Pharmacol 2014, Jan 15 [Epub ahead of print] http://dx.doi.org/10.1111/bcp.12292 7. Vik SA, Maxwell CJ, Hogan DB. Measurement, correlates, and health outcomes of medication adherence among seniors. Ann Pharmacother 2004;38:303-12. http://dx.doi.org/10.1345/aph.1D252 8. May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ 2009; 339:b2803. http://dx.doi.org/10.1136/bmj.b2803 9. National Institute for Health and Clinical Excellence. Depression in adults with a chronic physical health problem: treatment and management (National Clinical Practice Guideline Number 91 ). 10. Mercer SW, Guthrie B, Furler J, Watt GCM, Hart JT. Multimorbidity and the inverse care law in primary care. BMJ 2012;344:e4152. http://dx.doi.org/10.1136/bmj.e4152 11. Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings: systematic review. BMJ 2012;345:e5205. http://dx.doi.org/10.1136/bmj.e5205","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":" ","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2014.00018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40299044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update (GEDA) 2009 and 2010.","authors":"Henriette Steppuhn,&nbsp;Ute Langen,&nbsp;Thomas Keil,&nbsp;Christa Scheidt-Nave","doi":"10.4104/pcrj.2013.00107","DOIUrl":"https://doi.org/10.4104/pcrj.2013.00107","url":null,"abstract":"<p><strong>Background: </strong>Co-morbidities may complicate the clinical management of chronic conditions such as asthma.</p><p><strong>Aims: </strong>To quantify the strength of the relationship between asthma and other chronic diseases and to analyse whether co-morbidities contribute to unscheduled asthma care.</p><p><strong>Methods: </strong>Data from two consecutive national telephone health interview surveys (GEDA 2009 and 2010) including a total of 43,312 adults (>18 years of age) were analysed. Persons with and without a current diagnosis of asthma were compared with respect to concurrent diagnoses (diabetes mellitus, hypertension, chronic heart failure, depression, osteoarthritis, stroke, coronary heart disease, and cancer). Logistic regression models were applied to assess the strength of the association between asthma and co-morbidities in the total study population and, among persons with asthma, between the number of co-morbidities and unscheduled inpatient (hospital admissions and/or emergency department admissions) or outpatient asthma care in the past 12 months.</p><p><strong>Results: </strong>Overall, 5.3% (95% CI 5.0% to 5.6%) of adults reported current physician-diagnosed asthma. Asthma was significantly associated with most of the conditions considered and 18% of persons with asthma had three or more co-morbidities. Adjusted odds ratios (AOR) of unscheduled asthma care increased with numbers of conditions, with AOR 3.40 (95% CI 1.39 to 8.31) for unscheduled inpatient care and AOR 2.32 (95% CI 1.30 to 4.14) for unscheduled outpatient care comparing those with three or more co-morbidities versus those with none.</p><p><strong>Conclusions: </strong>The magnitude of chronic disease co-morbidity is substantial in asthma, is related to unscheduled asthma care, and implies a significant number of adults with asthma facing complex healthcare needs.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"22-9"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2013.00107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31962367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indolent pneumonia in a pregnant recent immigrant from Ethiopia: think TB.","authors":"Hashem Bishara, Moshe Lidji, Olga Vinitsky, Daniel Weiler-Ravell","doi":"10.4104/pcrj.2014.00001","DOIUrl":"10.4104/pcrj.2014.00001","url":null,"abstract":"<p><p>Time delay to tuberculosis (TB) diagnosis remains a public health concern. In pregnancy, early TB diagnosis is challenging and acquires further significance due to the risk of infection of the newborn as well as others in the maternity setting. We report a delay of 12 weeks in the diagnosis of TB in a pregnant recent immigrant from Ethiopia to Israel. Contact investigation revealed pulmonary TB in her two daughters aged four and seven years. We discuss the reasons for this delay in diagnosis, how a more timely diagnosis might have been made, and the dilemma of initiating treatment in unconfirmed TB. </p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"102-5"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32063488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National cohort data from Sweden to the National COPD audit in England and Wales: grand designs for quality improvement.","authors":"Rupert Jones,&nbsp;Michael Roberts","doi":"10.4104/pcrj.2014.00013","DOIUrl":"https://doi.org/10.4104/pcrj.2014.00013","url":null,"abstract":"National cohort data from Sweden to the National COPD audit in England and Wales: grand designs for quality improvement","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2014.00013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32140003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate prescribing of combination inhalers in Northern Ireland: retrospective cross-sectional cohort study of prescribing practice in primary care.","authors":"Joan Sweeney,&nbsp;Chris C Patterson,&nbsp;Stephen O'Neill,&nbsp;Ciaran O'Neill,&nbsp;Gillian Plant,&nbsp;Veranne Lynch,&nbsp;Teresa McAllister,&nbsp;Liam G Heaney","doi":"10.4104/pcrj.2014.00007","DOIUrl":"https://doi.org/10.4104/pcrj.2014.00007","url":null,"abstract":"<p><strong>Background: </strong>Asthma management guidelines advocate a stepwise approach to asthma therapy, including the addition of a long-acting bronchodilator to inhaled steroid therapy at step 3. This is almost exclusively prescribed as inhaled combination therapy.</p><p><strong>Aims: </strong>To examine whether asthma prescribing practice for inhaled combination therapy (inhaled corticosteroid/long-acting β2-agonist (ICS/LABA)) in primary care in Northern Ireland is in line with national asthma management guidelines.</p><p><strong>Methods: </strong>Using data from the Northern Ireland Enhanced Prescribing Database, we examined initiation of ICS/LABA in subjects aged 5-35 years in 2010.</p><p><strong>Results: </strong>A total of 2,640 subjects (67%) had no inhaled corticosteroid monotherapy (ICS) in the study year or six months of the preceding year (lead-in period) and, extending this to a 12-month lead-in period, 52% had no prior ICS. 41% of first prescriptions for ICS/LABA were dispensed in January to March. Prior to ICS/LABA prescription, in the previous six months only 17% had a short-acting β2-agonist (SABA) dispensed, 5% received oral steroids, and 17% received an antibiotic.</p><p><strong>Conclusions: </strong>ICS/LABA therapy was initiated in the majority of young subjects with asthma without prior inhaled steroid therapy. Most prescriptions were initiated in the January to March period. However, the prescribing of ICS/LABA did not appear to be driven by asthma symptoms (17% received SABA in the previous 6 months) or severe asthma exacerbation (only 5% received oral steroids). Significant reductions in ICS/LABA, with associated cost savings, would occur if the asthma prescribing guidelines were followed in primary care.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"74-8"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2014.00007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32155507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transgenerational occurrence of allergic disease and autoimmunity: general practice-based epidemiological research.","authors":"Tanja Maas,&nbsp;Chris Nieuwhof,&nbsp;Valeria Lima Passos,&nbsp;Caroline Robertson,&nbsp;Annelies Boonen,&nbsp;Robert B Landewé,&nbsp;J Willem Voncken,&nbsp;J André Knottnerus,&nbsp;Jan G Damoiseaux","doi":"10.4104/pcrj.2013.00108","DOIUrl":"https://doi.org/10.4104/pcrj.2013.00108","url":null,"abstract":"<p><strong>Background: </strong>Corresponding with the T helper cell type 1/T helper cell type 2 hypothesis, autoimmune and allergic diseases are considered pathologically distinct and mutually exclusive conditions. Co-occurrence of autoimmune disorders and allergy within patients, however, has been reported. Transgenerational co-occurrence of autoimmune and allergic disease has been less often described and may differ from the intra-patient results.</p><p><strong>Aims: </strong>To test the hypothesis that autoimmune disorders in parents are a risk factor for the development of an allergic disease in their offspring.</p><p><strong>Methods: </strong>Prospectively registered (by academic general practitioners) International Classifications of Primary Care (ICPC) for diagnoses of autoimmune disorders and allergy within families were evaluated (n=5,604 families) by performing multiple logistic regression analyses.</p><p><strong>Results: </strong>The presence of any ICPC-encoded autoimmune disorder in fathers appeared to be associated with an increased risk in their eldest children of developing an allergy (odds ratio (OR) 1.4, 95% CI 1.042 to 1.794). Psoriasis in fathers was particularly shown to be of influence (OR 1.5, 95% CI 1.061 to 2.117) and, although any ICPC-encoded autoimmune disease in mothers was found not to be of significance, the combined international code for registering rheumatoid arthritis/ankylosing spondylitis in mothers was OR 1.7 (95% CI 1.031 to 2.852).</p><p><strong>Conclusions: </strong>The occurrence of ICPC-encoded autoimmune disorders in parents, especially psoriasis and rheumatoid arthritis/ankylosing spondylitis, significantly increases the occurrence of allergic disease in their children. After validation in follow-up research in a larger sample, these results may lead to the inclusion of 'parental autoimmune condition' as a risk factor in the general practitioner's diagnostics of allergic disease.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2013.00108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32049104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the outcome of early childhood wheeze: mission impossible.","authors":"Paul L P Brand","doi":"10.4104/pcrj.2014.00010","DOIUrl":"https://doi.org/10.4104/pcrj.2014.00010","url":null,"abstract":"References 1. Quill TE, Abernethy AP. Generalist plus specialist palliative care--creating a more sustainable model. N Engl J Med 2013;368(13):1173-5. http://dx.doi.org/10.1056/NEJMp1215620 2. Luddington L, Cox S, Higginson I, Livesley B. The need for palliative care for patients with non-cancer diseases: a review of the evidence. Int J Palliat Nurs 2001;7(5):221-6. 3. Currow DC, Ward A, Clark K, Burns CM, Abernethy AP. Caregivers for people with end-stage lung disease: characteristics and unmet needs in the whole population. Int J Chron Obstruct Pulmon Dis 2008;3(4):753-62. 4. Girgis A, Abernethy AP, Currow DC. Caring at the end of life: do cancer caregivers differ from other caregivers? BMJ Support Palliat Care 2014;Published Online First 22 January 2014. http://dx.doi.org/10.1136/bmjspcare-2013-000495 5. Curtis JR. Palliative and end-of-life care for patients with severe COPD. Eur Respir J 2008;32(3):796-803. http://dx.doi.org/10.1183/09031936.00126107 6. Currow DC, Abernethy AP, Fazekas BS. Specialist palliative care needs of whole populations: a feasibility study using a novel approach. Palliat Med 2004;18(3):23947. http://dx.doi.org/10.1191/0269216304pm873oa 7. Epiphaniou C, Shipman C, Harding R, Mason B, Murray SAA, Higginson IJ, Daveson BA. Coordination of end-of-life care for patients with lung cancer and those with advanced COPD: are there transferable lessons? A longitudinal qualitative study. Prim Care Respir J 2014;23(1):46-51. http://dx.doi.org/10.4104/pcrj.2014.00004 8. Currow DC, Plummer JL, Crockett A, Abernethy AP. A community population survey of prevalence and severity of dyspnea in adults. J Pain Symptom Manage 2009;38(4):533-45. http://dx.doi.org/10.1016/j.jpainsymman.2009.01.006 9. Wagner EH, Ludman EJ, Aiello Bowles EJ, et al. Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 2014;32(1):12-18. http://dx.doi.org/10.1200/JCO.2013.51.7359 10. Pinnock H, Hanley J, McCloughan L, et al. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ 2013;347:f6070. http://dx.doi.org/10.1136/bmj.f6070 11. Abernethy AP, Currow DC, Hunt R, et al. A pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial of educational outreach visiting and case conferencing in palliative care-methodology of the Palliative Care Trial [ISRCTN 81117481]. Contemp Clin Trials 2006;27(1):83-100. http://dx.doi.org/10.1016/j.cct.2005.09.006 12. Abernethy AP, Currow DC, Shelby-James T, et al. Delivery strategies to optimize resource utilization and performance status for patients with advanced life-limiting illness: results from the \"palliative care trial\" [ISRCTN 81117481]. J Pain Symptom Manage 2013;45(3):488-505. http://dx.doi.org/10.1016/j.jpainsymman.2012.02.024 13. Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary in","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"10-1"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2014.00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32140057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of switching to new spirometric reference equations on severity staging of airflow obstruction in COPD: a crosssectional observational study in primary care.","authors":"Romina Sluga,&nbsp;Ivo J M Smeele,&nbsp;Annelies E Lucas,&nbsp;Bart P Thoonen,&nbsp;Joke G Grootens-Stekelenburg,&nbsp;Yvonne F Heijdra,&nbsp;Tjard R Schermer","doi":"10.4104/pcrj.2014.00006","DOIUrl":"https://doi.org/10.4104/pcrj.2014.00006","url":null,"abstract":"<p><strong>Background: </strong>Severity of airflow obstruction in chronic obstructive pulmonary disease (COPD) is based on forced expiratory volume in one second expressed as percentage predicted (FEV1%predicted) derived from reference equations for spirometry results.</p><p><strong>Aims: </strong>To establish how switching to new spirometric reference equations would affect severity staging of airflow obstruction in the Dutch primary care COPD patient population.</p><p><strong>Methods: </strong>Spirometry tests of 3,370 adults aged >40 years with obstruction (postbronchodilator FEV1/forced vital capacity (FVC) <0.70) were analysed. The presence and severity of obstruction were defined using Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Postbronchodilator FEV1%predicted was calculated using three reference equations: corrected European Community of Steel and Coal (ECSC) (currently recommended in Dutch primary care), Swanney et al., and Global Lung Initiative (GLI). Discordances between severity classifications based on these equations were analysed.</p><p><strong>Results: </strong>We studied 1,297 (38.5%) females and 2,073 males. Application of contemporary reference equations (i.e. Swanney and GLI) changed the GOLD severity stages obtained with the ECSC equations, mostly into milder stages. Severity of airflow obstruction was staged differently in 14.0% and 6.3%, respectively, when the Swanney et al. and GLI reference equations were applied.</p><p><strong>Conclusions: </strong>Compared with the (corrected) ECSC equations, switching to more contemporary reference equations would result in lower FEV1 predicted values and affect interpretation of spirometry by reclassifying 6-14% of primary care COPD patients into different (mostly milder) severity stages. If and how this will affect GPs' treatment choices in individual patients with COPD requires further investigation.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4104/pcrj.2014.00006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32153255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coordination of end-of-life care for patients with lung cancer and those with advanced COPD: are there transferable lessons? A longitudinal qualitative study.","authors":"Eleni Epiphaniou, Cathy Shipman, Richard Harding, Bruce Mason, Scott A A Murray, Irene J Higginson, Barbara A Daveson","doi":"10.4104/pcrj.2014.00004","DOIUrl":"10.4104/pcrj.2014.00004","url":null,"abstract":"<p><strong>Background: </strong>Care coordination is defined as good communication between professionals to enable access to services based on need.</p><p><strong>Aims: </strong>To explore patients' experience of care coordination in order to inform current debates on how best to coordinate care and deliver services in end-of-life for patients with lung cancer and those with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>A qualitative study involving serial interviews was performed in 18 patients recruited from three hospital outpatient clinics situated in a hospital. Interviews were transcribed verbatim and data were analysed thematically.</p><p><strong>Results: </strong>Data comprised 38 interviews. Patients experiencing services related to lung cancer reported good access enabled by the involvement of a keyworker. This contrasted with COPD patients' experiences of services. The keyworker coordinated care between and within clinical settings, referred patients to community palliative care services, helped them with financial issues, and provided support.</p><p><strong>Conclusions: </strong>For patients with lung cancer, the keyworker's role augmented access to various services and enabled care based on their needs. The experiences of patients with COPD highlight the importance of providing a keyworker for this group of patients in both secondary and primary care.</p>","PeriodicalId":48998,"journal":{"name":"Primary Care Respiratory Journal","volume":"23 1","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32074256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}