Multidisciplinary Respiratory Medicine最新文献

{"title":"Value of thoracic ultrasound including focused cardiac ultrasound in daily practice of outpatient chest clinic.","authors":"Moaz Atef, Houssam Eldin Hassanin, Ahmed M Ewis, Ahmed A Hassan, Ashraf Moursi, Ahmed S Sedeek, Ibrahim H Yousef, Bassam Abdellatif, Ahmed Attia, Magdy Shohdy, Abdelaziz Saeed, Zeinab R Adawy, Sawsan B Elsawy, Ahmed E Kabil","doi":"10.5826/mrm.2025.1033","DOIUrl":"10.5826/mrm.2025.1033","url":null,"abstract":"<p><strong>Background: </strong>Chest examination alone may be insufficient to declare cardiorespiratory diseases specially in its early stages and/or silent forms, also it is impractical for the CXR and cardiac consultation to be requested for every patient in the outpatient clinic, therefore involving the chest US and FoCUS (Focused Cardiac Ultra Sound) examination in the bedside practice of outpatient chest clinic may influence the clinical diagnosis and management plan.</p><p><strong>Objective: </strong>To determine how the bedside thoracic US including FoCUS can alter the clinical diagnosis in patients who are clinically diagnosed as acute bronchitis in the outpatient chest clinic.</p><p><strong>Subjects and methods: </strong>This study was conducted at Chest outpatient clinic, Al-Azhar University in the period between January 2024 to March 2025. 300 patients diagnosed clinically as acute bronchitis were evaluated by bedside chest ultrasound and FoCUS.</p><p><strong>Results: </strong>A prospective cross sectional study including 300 patients clinically diagnosed as acute bronchitis and evaluated by the bedside chest US including FoCUS which was additive and/or changing in clinical diagnosis in 31 (10.3%) of the studied patients, the sonographic evidence of pneumonia was present in 17 (5.7%) patients, the interstitial lung disease ILD was suggested in 5 (1.7%) patients, the clinic-sonographic diagnosis of heart failure was present in 7 (2.3%), the findings of mitral stenosis was present in 2 (0.7%).</p><p><strong>Conclusion: </strong>The practice of bedside chest US including FoCUS should not be restricted to the emergency rooms and ICUs but also should be extended to the outpatient clinic as it can diagnose unexpected clinical problems, guide to the next investigational step, and shorten the time to the clinical diagnosis and recovery.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016529","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":"Performance study of a new diagnostic questionnaire for (Chronic obstructive pulmonary -disease) COPD with information on exposure to wood smoke, COPD-WS.","authors":"Alejandra Lozano-Forero, Eduardo Tuta-Quintero, Alirio R Bastidas, Irma Méndez-Aguirre, Miguel A Molina, Julian Camacho, Ivan Guerrero, Laura Ramirez, Maria Perez, Laura Bravo, Silvia Rojas, Juan Mejia, Paula Salazar, Daniel Maestre, Juan Moreno, Laura Cabrera, Lina Borjas, Miguel Chacon","doi":"10.5826/mrm.2025.1007","DOIUrl":"10.5826/mrm.2025.1007","url":null,"abstract":"<p><strong>Background: </strong>To determine the diagnostic performance of a new questionnaire (COPD-WS) that considers also exposure to wood smoke for diagnosing Chronic Obstructive Pulmonary Disease (COPD) in a Colombian population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with analysis of diagnostic tests in subjects with and without COPD. Clinical variables were selected based on their relevance to COPD diagnosis, including age, sex, smoking status, exposure to wood smoke, dyspnea, cough, chronic expectoration, and wheezing. A bivariate analysis was performed with the diagnosis of COPD by spirometric criteria. The area under the receiver operating characteristic curve (AUROC) was calculated for the new questionnaire and compared with the LFQ, CDQ, PUMA, COULD IT BE COPD, and COPD-PS questionnaires. The cutoff point for the new questionnaire was obtained through the Youden index, and a p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 681 patients were included, 187 (27.5%) diagnosed with COPD. The mean age of the population was 65.9 (SD: ±11.79) years, with 53.7% being women and 58.3% having been exposed to wood smoke. The variables included in the questionnaire were age, sex, smoking status, exposure to wood smoke, dyspnea, cough, chronic expectoration, and wheezing. The AUROC for the new COPD-WS questionnaire was 0.69 (95%CI:0.65-0.74;p<0.001), and for a cutoff point ≥6, sensitivity was 0.711 (95%CI:0.677-0.745), specificity was 0.575 (95%CI:0.538-0.612), PPV was 0.388 (95% CI:0.351-0.424), NPV was 0.840 (95%CI:0.813-0.868), LR+ was 1.673 (95%CI:1.458-1.919), LR- was 0.502 (95% CI:0.438-0.576).</p><p><strong>Conclusion: </strong>This new questionnaire COPD-WS demonstrates acceptable diagnostic capability for diagnosis of COPD in this symptomatic population, and its performance is comparable to other questionnaires currently in use.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977672","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":"Perception of the role of Telemedicine in Interstitial Lung Diseases: -Findings from Società Italiana di Pneumologia/ Italian Respiratory -Society (SIP-IRS) survey.","authors":"Giorgio Monteleone, Gioele Castelli, Giovanni Franco, Marialuisa Bocchino, Luigi Carroccio, Francesca Lalla, Francesca Cefaloni, Silvia Deidda, Davide Chimera, Rosangela di Liberti, Giuseppe Muscato, Jacopo Simonetti, Bruno Iovene, Francesco Varone, Tommaso Pianigiani, Laura Bergantini, Miriana D'Alessandro, Giacomo Sgalla, Luca Richeldi, Elena Bargagli, Barbara Ruaro, Paolo Cameli","doi":"10.5826/mrm.2025.1026","DOIUrl":"10.5826/mrm.2025.1026","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine (TM) is increasingly recognised as a valuable tool in the management of interstitial lung diseases (ILDs). Despite its potential, its integration and application still remain limited. Our work aimed to assess pulmonologists' (physicians and trainees) perception regarding the use of TM in ILDs management.</p><p><strong>Methods: </strong>This national survey was created and distributed to all pulmonologists, both physicians and trainees, affiliated with Società Italiana di Pneumologia/Italian Respiratory Society (SIP/IRS). Responses were collected anonymously and analysed by using descriptive statistical analysis and the chi-square test.  Results: Among 2,906 invited participants, 44 completed the survey. While 95.5% of respondents considered TM useful in ILDs monitoring, only 36% reported its use in clinical practice. Current barriers included reduced availability of TM services (64%) and limited knowledge of TM software (56.8%). Moreover, the majority of participants referred a supportive but not substitutive role of TM in-person consultations, especially in monitoring and patient education. A significant proportion of repliers (over 50%) claimed that it may reduce waiting lists and enhance patient satisfaction (63.6%). However, concerns regarding data security and absence of standardised protocols were also reported.  Conclusions: TM is positively perceived by both physicians and trainees' pulmonologist for ILDs follow-up and educational purposes in ILD management. Nevertheless, its integration and application are still hindered by some concerns such as limited infrastructure and digital literacy as well as lack of standardisation of reimbursement protocols and evolving regulatory frameworks. Broader integration of TM will require to address these challenges through investments in technology, structured protocols, and training initiatives.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785925","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":"The real-life experience of a general pulmonary transition clinic.","authors":"Dejan Radovanovic, Lisa Milani, Francesca Mandurino Mirizzi, Antonella Forlano, Michele Ghezzi, Marco Morelli, Nicolò Garancini, Andrea Dubini, Alice Munari, Salvatore Zirpoli, Andrea Farolfi, Pierachille Santus","doi":"10.5826/mrm.2025.1038","DOIUrl":"10.5826/mrm.2025.1038","url":null,"abstract":"<p><strong>Background: </strong>Paediatric-to-adult transition represents an unmet need in many chronic conditions. Data and -outcomes on pulmonary transition clinics (PTC) are limited.  Methods: We report the structure, organization, and patients' characteristics of a multidisciplinary outpatient PTC started in 2022 by two secondary level academic hospitals in Milan, Italy. Consecutive adult patients  (≥18 years old) that entered the PTC from January 2022 until January 2023 and completed ≥2 follow-up visits were asked to answer a custom designed, anonymized, online questionnaire to test improvement in disease perception, self-confidence, and evaluate their experience with the clinic.  Results: Out of thirty-three patients, twenty-one completed the survey (62% males, median age 19 years). The most common diagnoses included asthma (57%) and bronchiectasis (19%). The disease control rate was optimal, only <2% of visits were unscheduled emergency visits. 100% of patients rated the presence of a dedicated service, a direct relationship with the treating physician and the possibility to improve self-management extremely useful.</p><p><strong>Conclusions: </strong>Our questionnaire revealed that transitioning from caregiver-based disease management to patient-based disease management was perceived as more arduous. PTCs are an impactful resource for patients transitioning to adult care, but our knowledge on disease specific management strategies in transitioning patients remains limited.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762245","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":"The dark side of pulmonary alveolar proteinosis.","authors":"Sara Lettieri, Francesca Mariani, Vincenzo Alfredo Marando, Elena Salvaterra, Angelo Guido Corsico, Ilaria Campo","doi":"10.5826/mrm.2025.1027","DOIUrl":"10.5826/mrm.2025.1027","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary alveolar proteinosis (PAP) has an unpredictable clinical course. Although usually benign, an association with pulmonary fibrosis is described in literature, with troubling therapeutic and prognostic implications.</p><p><strong>Clinical case: </strong>We report the case of a patient affected by autoimmune PAP who developed pleuro-parenchymal fibroelastosis (PPFE) after 6 years of disease and underwent bilateral lung transplantation due to end stage respiratory failure.</p><p><strong>Conclusion: </strong>Punctual descriptions of pulmonary fibrosis in PAP are still lacking and no predictors of fibrotic evolution of PAP are known. It is necessary to ensure a strict follow up in order to promptly recognize signs of fibrotic evolution and early refer patients with evolutive disease to lung transplant center. Moreover, an extended genetic analysis by targeted next-generation sequencing could provide high-resolution information that may allow the identification of susceptible patients in a pre-fibrotic stage of disease.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676442","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":"Tuberculosis treatment failure: what are the risk factors? A comprehensive literature review.","authors":"Karolina Kėvelaitienė, Valerija Edita Davidavičienė, Edvardas Danila","doi":"10.5826/mrm.2025.1030","DOIUrl":"10.5826/mrm.2025.1030","url":null,"abstract":"<p><p>Tuberculosis (TB), induced by Mycobacterium tuberculosis, is a significant global health concern. It affects approximately 25% of the global population and ranks among the primary causes of mortality from infectious diseases. Notwithstanding progress, TB treatment and diagnosis continue to encounter substantial obstacles, such as restricted access to precise diagnostics and efficacious therapies. By 2035, international objectives seek to diminish tuberculosis-related fatalities by 95% and enhance treatment accessibility. Multiple factors affect the success of TB treatment, including personal behaviors, social and demographic circumstances, and concurrent health conditions. Critical risk factors for suboptimal treatment outcomes encompass low body mass index, tobacco use, substance abuse, and various demographic variables, including gender, age, unemployment, geographic location, and migration status. Co-infections with HIV, diabetes, chronic kidney disease, and COVID-19 are associated with increased rates of treatment failure. Supplementary challenges, including loss to follow-up and drug-resistant TB, elevate the probability of treatment failure. This review's findings intend to furnish essential insights for policymakers, healthcare professionals, and TB control programs, enhancing strategies and interventions. The primary objective is to improve the efficacy of TB management globally, with an emphasis on attaining superior treatment outcomes, particularly in the most underserved regions.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576895","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":"Determination of the indoor air bacterial load and associated factors in primary schools in Hawassa City, Ethiopia, 2023. A comparative -cross-sectional study.","authors":"Samrawit Mokie Belayneh, Amanuel Ejeso, Asmare Asrat Yirdaw, Amanuel Atamo, Embialle Mengistie Beyene","doi":"10.5826/mrm.2025.1005","DOIUrl":"10.5826/mrm.2025.1005","url":null,"abstract":"<p><strong>Background: </strong>Indoor environments, particularly in schools, are a significant source of bacterial exposure, posing a public health risk. The aim of this study was to investigate the bacterial load and associated factors in the indoor environments of governmental and private primary schools in Hawassa, City, Ethiopia, 2023.</p><p><strong>Methods: </strong>A comparative cross-sectional study design was used in March, 2023; in 56 randomly selected classrooms focusing in five governmental and five private primary schools in Hawassa, City. The bacterial load was estimated using the settle-plate method of passive air sampling. Differences in the mean bacterial load between government and private primary schools were evaluated using a non-parametric test. Multiple linear regression analysis using log-transformed data was performed.</p><p><strong>Result: </strong>The average bacterial load in government primary schools was 8684.84 CFU/m3; while in private schools, it was 4396.43 CFU/m3. The isolated bacterial species included coagulase-negative Staphylococcus species (CoNS), gram-negative Bacillus species, gram-positive Bacillus species, and Staphylococcus aureus. A significant difference in the mean bacterial load (p=0.002) was observed between government and private primary schools with private primary schools showing lower levels. In government schools, the bacterial load was significantly associated with classroom cleanliness, occupant density, cleaning frequency, and classroom area. Conversely, the bacterial load in private schools showed strong association with the occupant density, cleaning frequency, relative humidity, and ventilation conditions.</p><p><strong>Conclusion: </strong>In government and private primary schools, the level of bacterial loads exceeded the WHO -criteria. This study revealed significant differences in indoor bacterial loads between government and private primary schools, with private schools showing lower levels. The correlation between bacterial load and environmental factors was distinct in each setting. As a recommendation; improving cleanliness, layout optimization, ventilation improvement, and hygiene education for both sectors, with regular air quality monitoring are crucial for tracking progress.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530931","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":"Viability of a new home program of forced spirometry with bronchodilator response measurement in the assessment of patients with asthma.","authors":"Héctor Cabrerizo Carreño, Cristina Bellver Asperilla, Ana Maria Romero-Ortiz, Salud Santos, Samantha Aso-González, Jaume Bordas-Martinez, Nuria Fabrellas, Eva Maria Guix-Comellas, Guillermo Suarez-Cuartin, Mariana Muñoz-Esquerre","doi":"10.5826/mrm.2025.1024","DOIUrl":"10.5826/mrm.2025.1024","url":null,"abstract":"<p><strong>Background: </strong>Home spirometry using portable devices offers a potential alternative for asthma management by reducing hospital dependence and improving accessibility. This study aimed to assess the feasibility of a home spirometry program with bronchodilator response (BDR) testing performed without direct medical supervision.  Methods: A prospective observational study was conducted with 47 asthma patients from a tertiary hospital. Participants received clear instructions and performed forced spirometry with BDR testing at home using a portable device. The primary outcomes included spirometry quality, variability compared to hospital tests, and patient satisfaction.</p><p><strong>Results: </strong>A total of 78% of participants achieved high-quality spirometry (A or B, according to ATS/ERS -criteria), despite greater variability in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) compared to hospital tests. However, the results remained clinically acceptable. Patients reported high satisfaction with the device, highlighting its ease of use and convenience.</p><p><strong>Conclusions: </strong>Home spirometry with BDR testing is a feasible tool for asthma follow-up, maintaining acceptable quality while reducing hospital-based testing. Although improvements are needed to minimize variability and enhance consistency, this program has the potential to optimize asthma management, increase accessibility, and reduce the burden on healthcare facilities.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217473","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":"Lung re-aeration assessment by ultrasound during mechanical ventilation: Current knowledge of literature review.","authors":"Paolo Formenti, Paolo Carlucci, Dejan Radovanovic, Giovanni Bruno, Gino Soldati, Francesco Tursi","doi":"10.5826/mrm.2025.1029","DOIUrl":"10.5826/mrm.2025.1029","url":null,"abstract":"<p><p>Lung collapse, commonly associated with conditions such as atelectasis, pneumonia, and acute respiratory distress syndrome, significantly impairs gas exchange and respiratory function. Monitoring lung re-aeration is therefore crucial in evaluating the effectiveness of therapeutic interventions, including non-invasive ventilation, invasive mechanical ventilation, and physiotherapy, which aim to restore lung volume and improve respiratory efficiency. Lung re-aeration involves two key physiological processes such as recruitment and inflation. Both mechanisms improve lung compliance and optimize ventilation-perfusion matching, improving overall respiratory function. LUS has emerged as a promising alternative for assessing lung aeration, supporting its feasibility in detecting and tracking lung re-aeration across various clinical scenarios, and providing real-time insights into lung recruitment and inflation. This review integrates current evidence on the physiological mechanisms of lung collapse and the clinical applications of ultrasound as a tool for monitoring lung re-aeration, highlighting its potential to optimize respiratory management in critically ill patients.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210191","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":"From acute phase to rehabilitation: bridging the gap and improving the pathway for Chronic Obstructive Pulmonary Diseases patients (Summary of a Pulmonologists' Audit - September-December 2024).","authors":"Michele Vitacca, Massimiliano Beccaria, Luca Bianchi, Paolo Ceruti, Maurizio Marvisi, Monia Betti, Michela Bezzi, Francesco Tursi","doi":"10.5826/mrm.2025.1023","DOIUrl":"10.5826/mrm.2025.1023","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines providing a detailed pathway for the management of chronic obstructive pulmonary disease (COPD), the Italian reality is characterized by underdiagnosis, organizational disharmony, and poor adherence to treatments. COPD entails significant economic and organizational costs, including healthcare expenses, delayed diagnoses, and fragmented management. Therapeutic approaches are often non-standardized and influenced by local practices.</p><p><strong>Methods: </strong>The audit presented here aims to provide suggestions to optimize COPD patient management, from the acute phase to stabilization, focusing on diagnosis, therapies, respiratory rehabilitation and follow-up, while proposing a coordinated pathway that could optimize patients and healthcare needs.</p><p><strong>Results: </strong>Eight specialists (1 internist and 7 pulmonologists) with extensive professional experience participated in the audit meetings. During three 4-hour sessions spread over three months, participants discussed background information, challenges and suggestions related to disease management. Topics were presented by designated leads, discussed by the group, and summarized into suggestions voted on using a Delphi-like process. Suggestions were approved if at least 75% of participants rated them above seven out of ten. The process produced a final list of shared suggestions. The audit group highlighted that the current management approach for COPD -patients-both in the stable phase and during exacerbations requiring hospital admission, discharge, and post-acute respiratory rehabilitation-remains fragmented, inconsistent, and poorly standardized. The group approved 29 improvement suggestions (21 achieved unanimous approval) across six main areas: a) The pathway for suspected or confirmed COPD patients; b) Therapy during the stable phase; c) Exacerbations/hospitalizations; d) Intensive care admissions requiring tracheostomy; e) Hospital discharge and f) Indications for respiratory rehabilitation.</p><p><strong>Conclusions: </strong>This work offers a unique pulmonologist's point of view and suggestions based on literature, best practices, and field experiences to improve collaboration among stakeholders and provide more effective care for COPD patients.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"20 ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081956","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}