Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation最新文献

{"title":"Challenges and Opportunities for the Management of COPD: A Narrative Review of Patient and Health Care Professional Perspectives.","authors":"Antonio Anzueto, Haley Hoy, Caroline Gainer","doi":"10.15326/jcopdf.2024.0597","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0597","url":null,"abstract":"<p><p>This review addresses the multifaceted challenges and opportunities in managing chronic obstructive pulmonary disease (COPD), from both the patient and healthcare professional (HCP) perspectives. Co-authored by a patient organization advocate, a pulmonologist, and a nurse practitioner, this article synthesizes insights gained through collaborative discussions and a comprehensive literature review. It highlights the critical importance of early diagnosis of COPD, emphasizing that delayed diagnosis can lead to significant underdiagnosis and mismanagement of the disease. Lung function declines more rapidly in the early stages of COPD. Therefore, delayed or underdiagnosed COPD results in a lost opportunity to improve or maintain lung function, prevent exacerbations, and enhance the quality of life. The typical patient journey is also outlined in this article, underscoring the necessity of encouraging patients to actively engage in their care. Patients and HCPs collectively call for improvements in COPD management, emphasizing the importance of maintenance therapy; a deeper understanding of COPD exacerbations, focusing on their prevention; and fostering a partnership between patients and their HCPs in care management. The role of HCPs is crucial in promoting the self-management and awareness of COPD among patients. By integrating patient perspectives into clinical practice, healthcare systems can better address the complex needs of patients with COPD and ultimately enhance their health outcomes.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an Inpatient COPD Care Pathway on Hospital Care Process and Outcome Metrics.","authors":"Nancy Kim, Wei Teng, Olukemi Akande, Deborah Rhodes, Carolyn L Rochester","doi":"10.15326/jcopdf.2024.0585","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0585","url":null,"abstract":"<p><strong>Background: </strong>Variable hospital care for COPD and underutilization of pulmonary rehabilitation (PR) may contribute to poor outcomes. Clinical pathways can optimize care by providing real-time decision support based on evidence and expert consensus. An inpatient COPD pathway was implemented in May 2021.</p><p><strong>Research question: </strong>To evaluate the impact of the COPD pathway on LOS, discharge disposition, resource use, PR referrals and readmissions.</p><p><strong>Study design and methods: </strong>A two-partCOPD pathway embedded into the electronic health record was built by multidisciplinary providers across a large academic medical center. Providers could place orders and document notes directly from the pathway. We identified all COPD hospitalizations one year after pathway implementation using International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes according to methods used by the Centers for Medicare & Medicaid Services.</p><p><strong>Results: </strong>766 patients contributed 971 hospitalizations. The pathway was opened in 142 (14.6%) hospitalizations. No significant differences in demographics, insurance or smoking status were noted between pathway versus non-pathway patients. Bivariate analyses demonstrated lower LOS (5.4 days v. 7.1 days, p=0.001) and total costs ($5,756 v. $8,781, p< 0.001) with pathway use, but no significant difference between 30-day readmissions (16% v 22%, p=0.12). In multivariable analysis, pathway use was associated with greater PR referrals (OR 5.76 95% CI 2.47-13.45, p<0.001) and discharges to home (OR 1.96 95% CI 1.13-3.39, p=0.016).</p><p><strong>Interpretation: </strong>Despite low utilization, pathway use was associated with more PR referrals and discharges to home with a trend toward lower LOS, resource use, and decreased readmissions.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COPD and Schizophrenia.","authors":"Sophie Ratcliffe, David M G Halpin","doi":"10.15326/jcopdf.2025.0631","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0631","url":null,"abstract":"<p><p>The prevalence of COPD is higher in people with schizophrenia than in the general population even after adjusting for smoking, but schizophrenia has not generally been considered in discussions of COPD multimorbidity. People with schizophrenia die prematurely and COPD is an important but neglected cause of this mortality. People with schizophrenia have a higher prevalence of ever smoking tobacco than the general population. The link between COPD and schizophrenia may be partially explained by higher rates of smoking, but may also be syndemic, with shared genetic, socioeconomic and environmental risk factors and common pathophysiological mechanisms. People with a mental illness tend to receive medical care intermittently, there is often a lack of continuity of care and primary and preventive services are infrequently used. Physical symptoms may be viewed as \"psychosomatic\" leading to under-diagnosis. People with schizophrenia are less likely to receive adequate general medical care, including investigation and treatment, in line with guidelines. Antipsychotic drugs are associated with adverse effects that may be problematic in people with COPD. The management and outcomes for people with schizophrenia and COPD could be improved by reducing stigma, developing Integrated services, undertaking physical health checks that include asking about respiratory symptoms and arranging spirometry when indicated, care coordination that includes addressing physical health issues, vaccination, support with smoking cessation, exercise and pulmonary rehabilitation.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Burden and Insights in COPD: A Survey Analysis.","authors":"David M Mannino, Sarina Trac, Jai Seth, Amy Dixon, Kavita Aggarwal, Brooks Kuhn","doi":"10.15326/jcopdf.2025.0616","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0616","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) affects millions of people and is associated with significant morbidity and mortality. Patients experience a high symptom burden with impacts on quality of life, which have not been well quantified.</p><p><strong>Methods: </strong>Phreesia's PatientInsights quantitative survey was offered during the month of January 2025 to patients with COPD during their check-in process for healthcare provider (HCP) visits. The survey comprised 28 questions. Survey question categories included COPD symptom experience and impact, and the treatment journey of patients with COPD. The survey also sought to identify potential communication gaps between patients and HCPs that might hinder effective COPD management.</p><p><strong>Results: </strong>Of 1,615 patients surveyed, most (59%) were female; the majority identified as White (82%). A total of 39% of patients had experienced COPD for over 7 years at the time the survey was conducted, and 25% reported experiencing symptoms all 30 days in a typical month. A large proportion (64%) said that COPD had a moderate-to-great impact on their daily lives. Only 45% of patients had detailed discussions about their COPD with their HCPs. Among patients who had not tried/were currently not on any maintenance medications (n=339), the leading reasons included that their COPD was not severe enough, and that their HCP had not recommended it. Among patients who had tried maintenance medications, the majority (77%) indicated that they would be willing to try another therapy.</p><p><strong>Conclusion: </strong>Improvements in patient-HCP communication are needed to achieve more effective, timely COPD management.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Response by Authors.","authors":"Wang Chun Kwok, Terence Chi Chun Tam, Chi Hung Chau, Fai Man Lam, James Chung Man Ho","doi":"10.15326/jcopdf.2025.0634","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0634","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":"12 3","pages":"210-211"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhalation Innovation: Optimizing COPD Care Through Clinical Pharmacist Integration in a Rehabilitation Hospital's Multidisciplinary Team - A Quality Improvement Study.","authors":"Annelies I M Walravens, Emma Walravens, Stephanie C M Wuyts, Sander Boudewyn, Kayleigh Spriet, Kristel De Paepe, Eline Tommelein","doi":"10.15326/jcopdf.2024.0569","DOIUrl":"10.15326/jcopdf.2024.0569","url":null,"abstract":"<p><strong>Background: </strong>Inhalation therapy is the cornerstone of chronic obstructive pulmonary disease (COPD) management. However, errors frequently occur since every type of inhalation device has different characteristics, complicating their use. The clinical pharmacist is an expert on these devices and can be involved in the care and education of inhaler use in patients with COPD.</p><p><strong>Objective: </strong>The feasibility of a pharmaceutical care protocol specifically for patients with COPD in a rehabilitation hospital was assessed in a quality improvement study (mixed-methods).</p><p><strong>Method: </strong>First, the clinical pharmacist had 6 contact moments with hospitalized patients between January and April 2022, which contained appropriateness evaluations and educational moments that were focused on inhalation techniques. Subsequently, a focus group discussion with all involved health care professionals (HCPs) took place to evaluate the preliminary results of the protocol's implementation.</p><p><strong>Results: </strong>A total of 19 patients entered the study with the protocol resulting in a decrease of critical device errors (38.5% at baseline, to 7.7% at discharge). The HCPs concluded that it was feasible to implement the protocol given certain adjustments. A multidisciplinary collaboration between pharmacists and nurses is necessary to permit the practical implementation, as well as an individualization of the protocol based on the patient's needs. In patient follow-up, transmural care is essential including the HCPs in primary care, and the outpatient clinic.</p><p><strong>Conclusion: </strong>The evaluation of the protocol by the involved HCPs emphasizes the importance of a clinical pharmacist in the care of patients with COPD as part of the multidisciplinary team, not only in the community or in an acute hospital setting, but also in a rehabilitation hospital.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"240-249"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of <i>Pseudomonas Aeruginosa</i> Colonization in Chronic Obstructive Pulmonary Disease Patients: Is There Enough Evidence?","authors":"Aikaterini Gakidi, Nicholas S Hopkinson, Michael I Polkey, Afroditi K Boutou","doi":"10.15326/jcopdf.2025.0627","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0627","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":"12 3","pages":"207-209"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Digital Inhaler to Assess COPD Disease Variability and Identify Impending Acute COPD Exacerbations: A Pilot Study.","authors":"M Bradley Drummond, Caleb C Hemphill, Tanisha Hill, Amanda Boe, Daisy Yu, Jill A Ohar","doi":"10.15326/jcopdf.2024.0555","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0555","url":null,"abstract":"<p><strong>Rationale: </strong>Studies have shown that digital inhalers, using remote monitoring data, can improve medication adherence and clinical outcomes, such as prediction of impending asthma exacerbations. There is limited research on the clinical utility of physiologic inhalation parameters and inhaler medication use data captured by a digital inhaler to identify impending acute exacerbations of chronic obstructive pulmonary disease (AECOPDs).</p><p><strong>Objectives: </strong>The objective was to determine variation in digital inhaler-measured physiologic and inhaler use metrics in ambulatory chronic obstructive pulmonary disease (COPD) patients in advance of an AECOPD.</p><p><strong>Methods: </strong>This phase 4, open-label, 3-month pilot study was conducted at 2 U.S. centers. Participants used the ProAir Digihaler for primary rescue medication during the study. Participants were contacted monthly for COPD disease assessments. Inhaler metric variations leading up to an AECOPD were evaluated.</p><p><strong>Results: </strong>The ProAir Digihaler measured key inhalation metrics (mean [standard deviation]) including peak inspiratory flow (PIF) (67.6 [20.3]L/min), inhalation volume (1.40 [0.60]L), and recorded inhaler use from 9649 inhalations among 40 participants. Statistically significant reductions were observed in inhalation volume (1.4L versus 1.1L), inhalation duration (1875msec versus 1492.1msec), and time to peak (500msec versus 376.3msec) (<i>p<</i>0.02 for all comparisons) during the 14 days preceding an AECOPD. There were no significant changes observed in PIF (67.2 versus 63.3, <i>p</i>=0.1) and number of inhalations per day (2.7 versus 3.7, <i>p</i>=0.2).</p><p><strong>Conclusion: </strong>Physiologic data captured by a digital inhaler may serve as a valuable remote patient monitoring tool to help support the identification of early or impending AECOPDs among ambulatory COPD patients and monitor COPD disease variability.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":"12 3","pages":"250-259"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of <i>Pseudomonas Aeruginosa</i> Colonization in Chronic Obstructive Pulmonary Disease Patients.","authors":"","doi":"10.15326/jcopdf.2024.0582E","DOIUrl":"10.15326/jcopdf.2024.0582E","url":null,"abstract":"<p><p>This corrects the article, \"Clinical Implications of Pseudomonas Aeruginosa Colonization in Chronic Obstructive Pulmonary Disease Patients,\" published in Volume 12, Issue 2, pp. 137-145.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"212"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychobiologic Correlates of Stress in Individuals With COPD.","authors":"Trish M Parekh, Rekha Ramachandran, Young-Il Kim, Zahra Haider, Darlene Bhavnani, J Michael Wells, Elizabeth Matsui, Mark T Dransfield","doi":"10.15326/jcopdf.2024.0578","DOIUrl":"10.15326/jcopdf.2024.0578","url":null,"abstract":"<p><strong>Background: </strong>Psychological stress is elevated in individuals with chronic medical conditions, including those with chronic obstructive pulmonary disease (COPD). Nail cortisol may have utility as a marker for testing the biologic effects of stress reduction interventions. The aim of this pilot study is to explore the use of nail cortisol as a marker of chronic psychological stress in individuals with COPD.</p><p><strong>Methods: </strong>Pearson's correlation was used to test if nail cortisol was correlated with perceived stress, serum cortisol, or inflammatory biomarkers. A multivariable linear regression model was used to evaluate the association between perceived stress and nail cortisol. Stepwise logistic regression modeling was used to determine associations of psychobiologic measures of stress with demographic, clinical, and psychological variables.</p><p><strong>Results: </strong>A total of 50 participants were included in the study. The mean (standard deviation [SD]) perceived stress score was 12 (+/-6) and mean (SD) nail cortisol level was 0.05 (+/-0.09) nmol/g. Nail cortisol was not correlated with perceived stress, serum cortisol, or inflammatory markers. There was no association between nail cortisol and perceived stress after controlling for confounders. Suboptimal health status and grit score were associated with perceived stress. Higher levels of serum fibrinogen were associated with higher levels of serum cortisol. Experiencing 3 or more negative lifetime events was associated with a decrease in nail cortisol.</p><p><strong>Conclusion: </strong>We found no correlation between nail cortisol and levels of perceived stress, serum cortisol, or inflammatory biomarkers and there were no similar associations of variables across psychobiologic measures of stress.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"213-222"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}