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

{"title":"Clinical Practices Surrounding the Prescription of Home Oxygen in Patients With COPD and Desaturation.","authors":"Sandra E Zaeh, Meredith Case, David H Au, Michele DaSilva, Karen Deitemeyer, Julie DeLisa, Laura C Feemster, Lynn B Gerald, Jerry A Krishnan, Jennifer Sculley, Annette Woodruff, Michelle N Eakin","doi":"10.15326/jcopdf.2023.0402","DOIUrl":"10.15326/jcopdf.2023.0402","url":null,"abstract":"<p><strong>Purpose: </strong>While home oxygen therapy increases survival in patients with chronic obstructive pulmonary disease (COPD) who have severe resting hypoxemia, recent evidence suggests that there is no survival benefit of home oxygen for patients with COPD who have isolated exertional desaturation. We aimed to understand clinician practice patterns surrounding the prescription of home oxygen for patients with COPD.</p><p><strong>Methods: </strong>We conducted semi-structured qualitative interviews via videoconference with 15 physicians and 3 nurse practitioners who provide care for patients with COPD. Clinicians were recruited through the American Lung Association Airways Clinical Research Centers. Interview guides were created with the assistance of patient investigators and included questions regarding clinician practices surrounding the prescription of oxygen for patients with COPD and the use of clinical guidelines. Interviews were recorded, transcribed, and coded for themes.</p><p><strong>Results: </strong>Of the 18 clinician interviewees, one-third were women, with most participants (n=11) being < 50 years old. Results of the semi-structured interviews suggested research evidence, clinical experience, and patient preferences contributed to clinician decision-making. Most clinicians described a shared decision-making process for prescribing home oxygen for patients, including discussion of risks and benefits, and developing an understanding of patient values and preferences. Clinicians did not use a structured tool to conduct these conversations.</p><p><strong>Conclusions: </strong>Clinicians consider a number of patient and clinical factors when prescribing home oxygen therapy, often using a shared decision-making process. Tools to support shared decision-making about the use of home oxygen are needed.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128984","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":"Chymotrypsin-like Elastase-1 Mediates Progressive Emphysema in Alpha-1 Antitrypsin Deficiency.","authors":"Andrew J Devine, Noah J Smith, Rashika Joshi, Qiang Fan, Michael T Borchers, Geremy C Clair, Joshua N Adkins, Brian M Varisco","doi":"10.15326/jcopdf.2023.0416","DOIUrl":"10.15326/jcopdf.2023.0416","url":null,"abstract":"<p><p>Chymotrypsin-like elastase 1 (CELA1) is a serine protease that is neutralized by alpha-1antitrypsin (AAT) and prevents emphysema in a murine antisense oligonucleotide model of AAT-deficient emphysema. Mice with genetic ablation of <i>AAT</i> do not have emphysema at baseline but develop emphysema with injury and aging. We tested the role of the <i>CELA1</i> gene in emphysema development in this genetic model of <i>AAT</i>-deficiency following tracheal lipopolysaccharide (LPS), 10 months of cigarette smoke exposure, aging, and a low-dose tracheal porcine pancreatic elastase (LD-PPE) model we developed. In this last model, we performed proteomic analysis to understand differences in lung protein composition. We were unable to show that <i>AAT</i>-deficient mice developed more emphysema than wild type with escalating doses of LPS. In the LD-PPE model, <i>AAT-</i>deficient mice developed significant and progressive emphysema from which <i>Cela1^-/-</i> & <i>AAT</i>-deficient mice were protected. <i>Cela1^-/-</i>& <i>AAT-</i>deficient lungs had more matrix-associated proteins than <i>AAT-</i>deficientlungs but also had more leukocyte-associated proteases. With cigarette smoke exposure, <i>Cela1^-/- &AAT</i>-deficient mice had more emphysema than <i>AAT-</i>deficient mice but had less myeloperoxidase activity. <i>Cela1^-/-&AAT</i>-deficient mice had less age-related airspace simplification than AAT-deficient and were comparable to wild type. While CELA1 promotes inflammation-independent emphysema progression and its absence preserves the lung matrix in multiple models of AAT-deficient emphysema, for unclear reasons <i>Cela1</i> deficiency is associated with increased emphysema with cigarette smoke. While anti-CELA1 therapies could potentially be used to prevent emphysema progression in AAT deficiency after smoking cessation, an understanding of why and how cigarette smoke exacerbates emphysema in <i>Cela1</i> deficiency and whether AAT replacement therapy mitigates this effect is needed first.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964908","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":"WITHDRAWN: Role of Oxidative Stress and Genetic Polymorphism of Matrix Metalloproteinase-2 and Tissue Inhibitor of Metalloproteinase-2 in COPD.","authors":"Poonam Sangwan, Huma Quasimi, Jai Gopal Sharma, Mohammad Anwar Habib, Mohammad Iqbal Alam","doi":"10.15326/jcopdf.2022.0370","DOIUrl":"10.15326/jcopdf.2022.0370","url":null,"abstract":"<p><p>Article in press withdrawn by publisher.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9951111","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":"Augmentation Therapy Modulates Systemic Inflammation in Individuals with Alpha-1 Antitrypsin Deficiency and Chronic Obstructive Pulmonary Disease.","authors":"J Lascano,&nbsp;L Riley,&nbsp;N Khodayari,&nbsp;M Brantly","doi":"10.15326/jcopdf.2023.0407","DOIUrl":"https://doi.org/10.15326/jcopdf.2023.0407","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin (AAT) deficiency is a genetic disorder that leads to chronic obstructive pulmonary disease (COPD) and lower circulating levels of AAT, which is a protease inhibitor with potent anti-inflammatory effects. In order to better understand the presence of systemic inflammation in AAT-deficient individuals with COPD, we investigatedthe plasma levels of C-reactive protein (CRP).</p><p><strong>Methods: </strong>AAT-deficient individuals and a matched cohort with a normal AAT genotype were recruited from the Alpha-1 Foundation DNA and Tissue Bank. AAT genotypes were determined by a combination of a Taqman-based assay. AAT and CRP levels were determined by nephelometry. Comparisons were determined by unpaired <i>t</i>-test and standard Pearson's correlation.</p><p><strong>Results: </strong>Our study included 40 control participants and 742 AAT-deficient participants, of which 498 received augmentation therapy. In the AAT-deficient participants, the plasma AAT was 20.2±11.6µM and 4.5±1.3µM (<i>P</i><0.0001) with and without augmentation therapy, respectively, and the CRP was 0.32±0.53mg/dL and 0.69±1.97mg/dL (<i>P</i>=0.0169), respectively. There was a negative correlation between the percentage predicted of forced expiratory volume in 1 second and CRP in the group not receiving augmentation therapy (r=-0.2528, <i>P</i><0.05), and there was no correlation in participants receiving augmentation therapy.</p><p><strong>Conclusion: </strong>Compared to healthy individuals, AAT-deficient individuals with COPD have higher levels of circulating CRP, suggesting increased systemic inflammation. However, AAT-deficient individuals receiving augmentation therapy had lower plasma CRP levels compared to those who are not.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484495/pdf/JCOPDF-10-308.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10187752","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":"Understanding the Patient Experience of Home-Based Pulmonary Rehabilitation with Health Coaching for COPD: A Qualitative Interview Study.","authors":"William R Midthun, Maria V Benzo, Jennifer L Ridgeway, Roberto P Benzo","doi":"10.15326/jcopdf.2022.0384","DOIUrl":"10.15326/jcopdf.2022.0384","url":null,"abstract":"<p><strong>Background: </strong>We recently reported on a randomized trial of home-based pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) that showed improvement in all domains of quality of life, accelerometry-measured physical activity, and self-management. In this current study, we used a theoretical framework to help us gain an in-depth understanding of how patients experience complex, multi-component programs to help uncover factors related to behavior change and to inform program scale-up in other populations.</p><p><strong>Study design and methods: </strong>The parent trial was conducted with COPD patients receiving care at an academic medical center and a community health system in the upper Midwest. The 12-week PR intervention included 3 daily video-guided exercises, activity monitors, and weekly telephonic health coaching. Trial participants were eligible to participate in an individual phone interview about their experience if they completed the intervention within the prior 12 months.. Analysis of verbatim transcripts followed an inductive thematic approach followed by deductive categorization and interpretation using a theoretical model: the Capability, Opportunity, Motivation-Behavior (COM-B) model developed for linking intervention functions to aspects of behavioral change.</p><p><strong>Results: </strong>Among 32 eligible program participants,32 were approached, and 15 completed interviews between October 19, 2021, and January 13, 2022. The COM-B model and recommendations for program improvement were observed in the primary findings.</p><p><strong>Discussion: </strong>Participants' feedback highlighted how the health coaching bolstered skills and confidence among individuals with the poorest function at program enrollment and how improved physical function and mood led to motivation. It also highlighted the roles of technology and telephonic support in a home-based program. Suggestions for improvement included providing exercise variations.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484487/pdf/JCOPDF-10-224.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536735","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":"Impact of Coronavirus Disease 2019 on Hospital Admissions, Health Status, and Behavioral Changes of Patients with COPD.","authors":"Eva Pappe,&nbsp;Ralf Hammerich,&nbsp;Jacopo Saccomanno,&nbsp;Thomas Sgarbossa,&nbsp;Anne Pohrt,&nbsp;Bernd Schmidt,&nbsp;Christian Grah,&nbsp;Stephan Eisenmann,&nbsp;Angelique Holland,&nbsp;Stephan Eggeling,&nbsp;Franz Stanzel,&nbsp;Martin Witzenrath,&nbsp;Ralf-Harto Hübner","doi":"10.15326/jcopdf.2022.0383","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0383","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of acquiring severe coronavirus disease 2019 (COVID-19), which is why self-isolation was recommended. However, long periods of social isolation, accompanied by limited access to health care systems, might influence the outcome of patients with severe COPD negatively.</p><p><strong>Methods: </strong>Data from COPD and pneumonia patients at Charité-Universitätsmedizin Berlin and the volume of endoscopic lung volume reduction (ELVR) surgeries from the German Lung Emphysema Registry (<i>Lungenemphysem Register e.V</i>.) were analyzed from pre-pandemic (2012 to 2019) to the pandemic period (2020 and 2021). In addition, 52 patients with COPD Global initiative for chronic Obstructive Lung Disease (GOLD) stage 4 status included in the lung emphysema registry received questionnaires during lockdowns from June 2020 to April 2021.</p><p><strong>Results: </strong>Admissions and ventilation therapies administered to COPD patients significantly decreased during the COVID-19 pandemic. Likewise, there was a reduction in ELVR treatments and follow-ups registered in German emphysema centers. Mortality was slightly higher among patients hospitalized with COPD during the pandemic. Increasing proportions of COPD patients with GOLD stage 3 and GOLD stage 4 status reported behavioral changes and subjective feelings of increasing COPD symptoms the longer the lockdown lasted. However, COPD symptom questionnaires revealed stable COPD symptoms over the pandemic time period.</p><p><strong>Summary: </strong>This study reveals reduced COPD admissions and elective treatment procedures of COPD patients during the pandemic, but a slight increase in mortality among patients hospitalized with COPD, irrespective of COVID-19. Correspondingly, patients with severe COPD reported subjective deterioration of their health status, probably caused by their very strict compliance with lockdown measures.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484494/pdf/JCOPDF-10-211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536734","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":"Changes in Lung Volumes with Spirometric Disease Progression in COPD.","authors":"Mehrdad Arjomandi, Siyang Zeng, Jianhong Chen, Surya P Bhatt, Fereidoun Abtin, Igor Barjaktarevic, R Graham Barr, Eugene R Bleecker, Russell G Buhr, Gerard J Criner, Alejandro P Comellas, David J Couper, Jeffrey L Curtis, Mark T Dransfield, Spyridon Fortis, MeiLan K Han, Nadia N Hansel, Eric A Hoffman, John E Hokanson, Robert J Kaner, Richard E Kanner, Jerry A Krishnan, Wassim W Labaki, David A Lynch, Victor E Ortega, Stephen P Peters, Prescott G Woodruff, Christopher B Cooper, Russell P Bowler, Robert Paine, Stephen I Rennard, Donald P Tashkin","doi":"10.15326/jcopdf.2022.0363","DOIUrl":"10.15326/jcopdf.2022.0363","url":null,"abstract":"<p><strong>Background: </strong>Abnormal lung volumes representing air trapping identify the subset of smokers with preserved spirometry who develop spirometric chronic obstructive pulmonary disease (COPD) and adverse outcomes. However, how lung volumes evolve in early COPD as airflow obstruction develops remains unclear.</p><p><strong>Methods: </strong>To establish how lung volumes change with the development of spirometric COPD, we examined lung volumes from the pulmonary function data (seated posture) available in the U.S. Department of Veterans Affairs electronic health records (n=71,356) and lung volumes measured by computed tomography (supine posture) available from the COPD Genetic Epidemiology (COPDGene^®) study (n=7969) and the SubPopulations and InterMediate Outcome Measures In COPD Study (SPIROMICS) (n=2552) cohorts, and studied their cross-sectional distributions and longitudinal changes across the airflow obstruction spectrum. Patients with preserved ratio-impaired spirometry (PRISm) were excluded from this analysis.</p><p><strong>Results: </strong>Lung volumes from all 3 cohorts showed similar patterns of distributions and longitudinal changes with worsening airflow obstruction. The distributions for total lung capacity (TLC), vital capacity (VC), and inspiratory capacity (IC) and their patterns of change were nonlinear and included different phases. When stratified by airflow obstruction using Global initiative for chronic Obstructive Lung Disease (GOLD) stages, patients with GOLD 1 (mild) COPD had larger lung volumes (TLC, VC, IC) compared to patients with GOLD 0 (smokers with preserved spirometry) or GOLD 2 (moderate) disease. In longitudinal follow-up of baseline GOLD 0 patients who progressed to spirometric COPD, those with an initially higher TLC and VC developed mild obstruction (GOLD 1) while those with an initially lower TLC and VC developed moderate obstruction (GOLD 2).</p><p><strong>Conclusions: </strong>In COPD, TLC, and VC have biphasic distributions, change in nonlinear fashions as obstruction worsens, and could differentiate those GOLD 0 patients at risk for more rapid spirometric disease progression.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484496/pdf/JCOPDF-10-270.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185690","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":"Structured Evaluation and Management of Patients with COPD in an Accredited Program.","authors":"Mandeep Singh,&nbsp;En Shuo Hsu,&nbsp;Efstathia Polychronopoulou,&nbsp;Gulshan Sharma,&nbsp;Alexander G Duarte","doi":"10.15326/jcopdf.2022.0366","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0366","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition.</p><p><strong>Methods: </strong>We compared the impact of care received by patients with COPD at Joint Commission-accredited, disease-specific clinics and primary care clinics at an academic health care systemfrom April 2014 to March 2018. Patients with COPD ≥ 40 years old with ≥ 2 outpatient visits 30 days apart were identified. Baseline demographics, disease-specific performance measures, and health care utilization were compared between groups. Propensity matching was conducted and time to the first emergency department (ED) visit and hospitalization was performed using Cox regression analysis.</p><p><strong>Results: </strong>Of 4646 unique patients with COPD, 1114 were treated at disease-specific clinics and 3532 at primary care clinics. The entire group was predominantly female (58.8 %), non-Hispanic White (74.2 %) with a mean age of 65.4 ± 11.4 years consisting of current (47.6 %) or former smokers (38.4 %). In the disease-specific group, performance measures were performed more frequently, and lower rates of ED visits (hazard ratio [HR]=0.31, 95% confidence interval [CI] 0.18-0.54) and hospitalizations (HR 0.41, 95% CI 0.21-0.79) noted in comparison to the primary care group.</p><p><strong>Conclusions: </strong>In this observational study, the implementation of achronic disease management program through accredited disease-specific clinics for patients with COPD was associated with reduced all-cause ED visits and hospitalizations.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484492/pdf/JCOPDF-10-297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10175641","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 Use of an Exposure, Symptom, and Spirometry Algorithm to Stratify Smokers into COPD Risk Phenotypes: A Case Finding Study Combined with Smoking Cessation Counseling.","authors":"Abraham Bohadana,&nbsp;Ariel Rokach,&nbsp;Pascal Wild,&nbsp;Ofir Kotek,&nbsp;Chen-Chen Shuali,&nbsp;Hava Azulai,&nbsp;Gabriel Izbicki","doi":"10.15326/jcopdf.2022.0368","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0368","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) case-finding aims to detect airflow obstruction in symptomatic smokers and ex-smokers. We used a clinical algorithm including smoking, symptoms, and spirometry to classify smokers into COPD risk phenotypes. In addition, we evaluated the acceptability and effectiveness of including smoking cessation advice in the case-finding intervention.</p><p><strong>Methods: </strong>Smoking, symptoms, and spirometry abnormalities (airflow obstruction: forced expiratory volume in 1 second [FEV₁] to forced vital capacity [FVC] <0.7 or preserved-ratio spirometry (FEV₁<80% of predicted value and FEV₁/FVC ratio ≥ 0.7)] were assessed in a group of 864 smokers aged ≥ 30 years. The combination of these parameters allowed the identification of 4 phenotypes: Phenotype A (no symptoms, normal spirometry; reference), Phenotype B (symptoms; normal spirometry; possible COPD), Phenotype C (no symptoms; abnormal spirometry; possible COPD), and Phenotype D (symptoms; abnormal spirometry; probable COPD). We assessed phenotype differences in clinical variables and modeled the trend from phenotype A to phenotype D. Smoking cessation advice based on spirometry was provided. Follow-up was done by telephone 3 months later.</p><p><strong>Results: </strong>Using smokers without symptoms or abnormal spirometry (phenotype A; n=212 [24.5%]) as a reference, smokers were classified into possible COPD (phenotype B;n=332 [38.4%]; and C: n=81 [9.4%]) and probable COPD (phenotype D: n=239 [27.2%]). The trend from baseline phenotype A to probable COPD phenotype D was significant for the number of cigarettes/day and the number of years of smoking (<i>p</i>=0.0001). At follow-up, 58 (7.7%) of the respondents (n=749) reported that they had quit smoking.</p><p><strong>Conclusions: </strong>Our clinical algorithm allowed us to classify smokers into COPD phenotypes whose manifestations were associated with smoking intensity and to significantly increase the number of smokers screened for COPD. Smoking cessation advice was well accepted, resulting in a low but clinically significant quit rate.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484490/pdf/JCOPDF-10-248.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185691","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 Experiences of Individuals with a History of Acute Exacerbations of COPD and Their Thoughts on Death: Empirical Qualitative Research.","authors":"Yasemin Ceyhan","doi":"10.15326/jcopdf.2023.0389","DOIUrl":"10.15326/jcopdf.2023.0389","url":null,"abstract":"<p><strong>Background: </strong>The most important problem of chronic obstructive pulmonary disease (COPD) patients is acute exacerbation. Researching this experience and examining its relationship with death is extremely important in patient care.</p><p><strong>Methods: </strong>This study was conducted to reveal the experiences of individuals with a history of acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) and their thoughts on death by qualitative empirical research. The study was conducted in a pulmonology clinic between July and September 2022. In-depth face-to-face interviews were conducted with patients in their rooms using a semi-structured form created specifically for the study and used as a data collection tool. With patient consent, interviews were recorded and documented. During the data analysis phase, the Colaizzi method was used. The study was presented in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for qualitative research.</p><p><strong>Results: </strong>The study was completed with 15 patients. A total of 13 of the patients were male and the mean age was 65 years. Patient statements were coded after the interviews and collected under 11 sub-themes. These sub-themes were categorized under the following main themes: recognizing AECOPDs, AECOPD instant experiences, post-AECOPD, and thoughts on death.</p><p><strong>Conclusion: </strong>Patients were able to recognize the symptoms of an AECOPD, that the severity of the symptoms increased during the exacerbation, that they felt regret or anxiety about re-exacerbation, and that all of these factors contributed to their fear of death.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484489/pdf/JCOPDF-10-259.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540689","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}