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

{"title":"COPD and Schizophrenia.","authors":"Sophie Ratcliffe, David M G Halpin","doi":"10.15326/jcopdf.2025.0631","DOIUrl":"10.15326/jcopdf.2025.0631","url":null,"abstract":"<p><p>The prevalence of chronic obstructive pulmonary disease (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 underdiagnosis. 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":"328-338"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429534/pdf/","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":"OA","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":"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 PatientInsightsquantitative survey was offered in January 2025 to patients with COPD during their check-in process for health care 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 1615 patients surveyed, most (59%) were female, and 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>Conclusions: </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":"317-327"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429533/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212363/pdf/","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":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212366/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212359/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212364/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Chronic Airways Assessment Test (CAAT™): Evolution From the COPD Assessment Test (CAT™).","authors":"Ruth Tal-Singer, James D Chalmers, Paul W Jones, Helen K Reddel, Toru Oga, Claus F Vogelmeier, Janelle Yorke, Bruce E Miller","doi":"10.15326/jcopdf.2025.0614","DOIUrl":"10.15326/jcopdf.2025.0614","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":"12 3","pages":"203-206"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.","authors":"Katherine Hickman, Yasir Tarabichi, Andrew P Dickens, Rachel Pullen, Margee Kerr, Amy Couper, Alexander Evans, James Gatenby, Luis Alves, Cono Ariti, Mona Bafadhel, Victoria Carter, James Chalmers, Rongchang Chen, Graham Devereux, M Bradley Drummond, J Martin Gibson, David M G Halpin, MeiLan Han, Nicola A Hanania, John R Hurst, Alan Kaplan, Konstantinos Kostikas, Barry Make, Douglas Mapel, Jonathan Marshall, Fernando Martinez, Catherine Meldrum, Marije van Melle, Marc Miravitlles, Tamsin Morris, Hana Mullerova, Ruth Murray, Shigeo Muro, Clementine Nordon, Jill Ohar, Wilson Pace, Michael Pollack, Jennnifer K Quint, Anita Sharma, Dave Singh, Mukesh Singh, Frank Trudo, Dennis Williams, Tom Wilkinson, Tonya Winders, David Price","doi":"10.15326/jcopdf.2024.0564","DOIUrl":"10.15326/jcopdf.2024.0564","url":null,"abstract":"<p><strong>Background: </strong>The burden of chronic obstructive pulmonary disease (COPD) is well established, but opportunities for earlier diagnosis and improved management are still missed. Compared to the general COPD population, patients with a history of exacerbations and suboptimal treatment (\"modifiable high-risk\") are at greater risk of future exacerbations and adverse health outcomes. To date there is no systematic approach for identifying and treating this patient group.</p><p><strong>Method: </strong>Two cluster randomized controlled trials (CRTs) in the United Kingdom and United States will assess the impact of a primary care-based quality improvement program (COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care [CONQUEST]), compared to routine care. In each trial, 126 primary care clusters will be randomized 1:1 to intervention or control arms. Three groups of modifiable high-risk patients will be identified using electronic medical records: undiagnosed with potential COPD, newly diagnosed COPD, and already diagnosed COPD. Eligible patients will be aged ≥40 years, have experienced ≥2 moderate/≥1 severe exacerbation(s) in the prior 24 months, including ≥1 in the last 12 months, and not be prescribed inhaled triple therapy. Patients in the undiagnosed group will also be required to have a positive smoking history. Primary trial outcomes will be the annual rate of exacerbations and the annual rate of major adverse cardiac or respiratory events, comparing the quality improvement program against routine care.</p><p><strong>Discussion: </strong>These will be the first CRTs assessing such a comprehensive primary care-based COPD quality improvement program. Intention-to-treat analysis of trial outcomes after 24 months will inform its effectiveness in targeting the identification, assessment, treatment, and follow-up of patients with modifiable high-risk COPD.</p><p><strong>Trial registration: </strong>UK trial: ISRCTN15819828; US trial: NCT05306743.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"223-239"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212365/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychobiologic Correlates of Stress in Individuals With COPD.","authors":"Trisha 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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212360/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}