BMJ Open Respiratory Research最新文献

{"title":"Automated oxygen titration with non-invasive ventilation in hypoxaemic adults with cardiorespiratory disease: a randomised cross-over trial.","authors":"Louis Kirton, Stacey Kung, Georgina Bird, Melissa Black, Ruth Semprini, Allie Eathorne, Mark Weatherall, Alex Semprini, Richard Beasley","doi":"10.1136/bmjresp-2023-002196","DOIUrl":"10.1136/bmjresp-2023-002196","url":null,"abstract":"<p><strong>Background: </strong>Closed-loop oxygen control systems automatically adjust the fraction of inspired oxygen (FiO₂) to maintain oxygen saturation (SpO₂) within a predetermined target range. Their performance with low and high-flow oxygen therapies, but not with non-invasive ventilation, has been established. We compared the effect of automated oxygen on achieving and maintaining a target SpO₂ range with nasal high flow (NHF), bilevel positive airway pressure (bilevel) and continuous positive airway pressure (CPAP), in stable hypoxaemic patients with chronic cardiorespiratory disease.</p><p><strong>Methods: </strong>In this open-label, three-way cross-over trial, participants with resting hypoxaemia (n=12) received each of NHF, bilevel and CPAP treatments, in random order, with automated oxygen titrated for 10 min, followed by 36 min of standardised manual oxygen adjustments. The primary outcome was the time taken to reach target SpO₂ range (92%-96%). Secondary outcomes included time spent within target range and physiological responses to automated and manual oxygen adjustments.</p><p><strong>Results: </strong>Two participants were randomised to each of six possible treatment orders. During automated oxygen control (n=12), the mean (±SD) time to reach target range was 114.8 (±87.9), 56.6 (±47.7) and 67.3 (±61) seconds for NHF, bilevel and CPAP, respectively, mean difference 58.3 (95% CI 25.0 to 91.5; p=0.002) and 47.5 (95% CI 14.3 to 80.7; p=0.007) seconds for bilevel and CPAP versus NHF, respectively. Proportions of time spent within target range were 68.5% (±16.3), 65.6% (±28.7) and 74.7% (±22.6) for NHF, bilevel and CPAP, respectively.Manually increasing, then decreasing, the FiO₂ resulted in similar increases and then decreases in SpO₂ and transcutaneous carbon dioxide (PtCO₂) with NHF, bilevel and CPAP.</p><p><strong>Conclusion: </strong>The target SpO₂ range was achieved more quickly when automated oxygen control was initiated with bilevel and CPAP compared with NHF while time spent within the range across the three therapies was similar. Manually changing the FiO₂ had similar effects on SpO₂ and PtCO₂ across each of the three therapies.</p><p><strong>Trial registration number: </strong>ACTRN12622000433707.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National trend in the prevalence and mortality of COPD in South Korea from 2008 to 2017.","authors":"Sun-Hyung Kim, Jong Eun Park, Bumhee Yang, So Young Kim, Yeon Yong Kim, Jong Hyock Park","doi":"10.1136/bmjresp-2024-002391","DOIUrl":"10.1136/bmjresp-2024-002391","url":null,"abstract":"<p><strong>Background: </strong>Existing studies on chronic obstructive pulmonary disease (COPD) in Korea lack full population coverage, relying on small sample sizes. Therefore, this study aims to investigate the prevalence and mortality of COPD in the entire Korean population.</p><p><strong>Methods: </strong>This serial cross-sectional study used national databases, linking the National Health Information Database (2008-2017) with Causes of Death Statistics. Identification of individuals with COPD used diagnostic codes (International Classification of Diseases-10: J41-J44) or a history of COPD-related hospitalisation, focusing on adults aged 40 and above. Prevalence and mortality rates, calculated for 2008-2017, encompassed both crude and age-standardised and sex-standardised measures. A multivariate Poisson regression model estimated the association between COPD and all-cause and cause-specific mortality, presenting incidence rate ratios (IRRs) and 95% CIs, using data from the year 2017.</p><p><strong>Results: </strong>Age-adjusted COPD prevalence exhibited a notable increase from 2008 (7.9%) to 2017 (16.7%) in both sexes. The prevalences of diabetes mellitus, hypertension, dyslipidaemia, ischaemic heart disease, cancer, osteoporosis and tuberculosis were higher in the COPD group than in the group without COPD (p for all <0.001). The incidence of stroke and myocardial infarction (p for all <0.001) and overall mortality were higher in the COPD group (adjusted IRR 1.23, 95% CI 1.22 to 1.24, p<0.001). In particular, incidence rate and risk of mortality due to lung cancer were higher than that of those without COPD compared with other cancer types (adjusted IRR 2.51, 95% CI 2.42 to 2.60, p<0.001). It was significantly higher the incidence rate and risk of mortality among group with COPD than those without COPD in lower respiratory disease (adjusted IRR 16.62, 95% CI 15.07 to 18.33, p<0.001), asthma (adjusted IRR 6.41, 95% CI 5.47 to 7.51, p<0.001) and bronchiectasis (adjusted IRR 11.77, 95% CI 7.59 to 18.26, p<0.001), respectively.</p><p><strong>Discussion: </strong>Our study showed that the prevalence of COPD is gradually increasing from 9.2% in 2009 to 16.7% in 2018. Furthermore, in overall (all-cause) mortality, it was significantly higher in group with COPD than in group without COPD. The mortality rate of group with COPD was much higher than the overall mortality rate but is gradually decreasing.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes zoster burden in patients with asthma: real-world incidence, healthcare resource utilisation and cost.","authors":"David Singer, Philippe Thompson-Leduc, Siyu Ma, Deepshekhar Gupta, Wendy Y Cheng, Aruna Muthukumar, Francesca Devine, Manasvi Sundar, Michael Bogart, Ella Hagopian, Sara Poston, Mei Sheng Duh, John J Oppenheimer","doi":"10.1136/bmjresp-2023-002130","DOIUrl":"10.1136/bmjresp-2023-002130","url":null,"abstract":"<p><strong>Background: </strong>Herpes zoster (HZ) is a painful condition caused by reactivation of the varicella-zoster virus. The objectives of this study were to compare HZ incidence in adults with asthma versus adults without asthma and to compare healthcare resource use as well as direct costs in adults with HZ and asthma versus adults with asthma alone in the USA.</p><p><strong>Methods: </strong>This retrospective longitudinal cohort study included adults aged ≥18 years across the USA. Patients were identified from Optum's deidentified Clinformatics Data Mart Database, an administrative claims database, between 1 October 2015 and 28 February 2020, including commercially insured and Medicare Advantage with part D beneficiaries. Cohorts of patients with and without asthma, and separate cohorts of patients with asthma and HZ and with asthma but not HZ, were identified using International Classification of Diseases 10th Revision, Clinical Modification codes. HZ incidence, healthcare resource use and costs were compared, adjusting for baseline characteristics, between the relevant cohorts using generalised linear models.</p><p><strong>Results: </strong>HZ incidence was higher in patients with asthma (11.59 per 1000 person-years) than patients without asthma (7.16 per 1000 person-years). The adjusted incidence rate ratio (aIRR) for HZ in patients with asthma, compared with patients without asthma, was 1.34 (95% CI 1.32 to 1.37). Over 12 months of follow-up, patients with asthma and HZ had more inpatient stays (aIRR 1.11; 95% CI 1.02 to 1.21), emergency department visits (aIRR 1.26; 95% CI 1.18 to 1.34) and outpatient visits (aIRR 1.19; 95% CI 1.16 to 1.22), and direct healthcare costs that were US dollars ($) 3058 (95% CI $1671 to $4492) higher than patients with asthma without HZ.</p><p><strong>Conclusion: </strong>Patients with asthma had a higher incidence of HZ than those without asthma, and among patients with asthma HZ added to their healthcare resource use and costs.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared genetic aetiology of respiratory diseases: a genome-wide multitraits association analysis.","authors":"Zhe Chen, Ning Gao, Xuanye Wang, Xiangming Chen, YaQi Zeng, Cong Li, Xiahong Yang, Qidong Cai, Xiang Wang","doi":"10.1136/bmjresp-2023-002148","DOIUrl":"10.1136/bmjresp-2023-002148","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the common genetic basis between respiratory diseases and to identify shared molecular and biological mechanisms.</p><p><strong>Methods: </strong>This genome-wide pleiotropic association study uses multiple statistical methods to systematically analyse the shared genetic basis between five respiratory diseases (asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, lung cancer and snoring) using the largest publicly available genome wide association studies summary statistics. The missions of this study are to evaluate global and local genetic correlations, to identify pleiotropic loci, to elucidate biological pathways at the multiomics level and to explore causal relationships between respiratory diseases. Data were collected from 27 November 2022 to 30 March 2023 and analysed from 14 April 2023 to 13 July 2023.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes are shared genetic loci, pleiotropic genes, biological pathways and estimates of genetic correlations and causal effects.</p><p><strong>Results: </strong>Significant genetic correlations were found for 10 paired traits in 5 respiratory diseases. Cross-Phenotype Association identified 12 400 significant potential pleiotropic single-nucleotide polymorphism at 156 independent pleiotropic loci. In addition, multitrait colocalisation analysis identified 15 colocalised loci and a subset of colocalised traits. Gene-based analyses identified 432 potential pleiotropic genes and were further validated at the transcriptome and protein levels. Both pathway enrichment and single-cell enrichment analyses supported the role of the immune system in respiratory diseases. Additionally, five pairs of respiratory diseases have a causal relationship.</p><p><strong>Conclusions and relevance: </strong>This study reveals the common genetic basis and pleiotropic genes among respiratory diseases. It provides strong evidence for further therapeutic strategies and risk prediction for the phenomenon of respiratory disease comorbidity.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet-delivered cognitive-behaviour therapy for anxiety related to asthma: study protocol for a randomised controlled trial.","authors":"Marianne Bonnert, Stephen Nash, Erik M Andersson, Sten Erik Bergström, Christer Janson, Catarina Almqvist","doi":"10.1136/bmjresp-2023-002035","DOIUrl":"10.1136/bmjresp-2023-002035","url":null,"abstract":"<p><strong>Introduction: </strong>There is an established association between asthma and anxiety. The overlap between asthma symptoms and symptoms of anxiety may cause individuals to overestimate their asthma severity and restrict their daily activities leading to a low quality of life. There is currently weak evidence for treatments targeting anxiety related to asthma, but cognitive-behavioural therapy (CBT) has shown some promising but mixed results. The current randomised controlled trial will investigate if exposure-based internet-delivered CBT (Internet-CBT) is more effective than treatment as usual+medical education (TAU+ME) to relieve symptoms of anxiety and asthma control.</p><p><strong>Methods and analysis: </strong>90 participants will be randomised 1:1 to 8 weeks of Internet-CBT or TAU+ME. The primary outcome, the patient-reported Catastrophising Asthma Scale, will be analysed from baseline to the primary endpoint at 16 weeks using hierarchical linear mixed model of the slope over time. Secondary outcomes, such as asthma control, quality of life and forced expiratory volume in 1 s, will be analysed correspondingly.</p><p><strong>Ethics and dissemination: </strong>All participants will be informed about the study and leave their consent before study entry. All results will be analysed at group level and reported through publication in a peer-reviewed scientific journal within the field. The study received ethical approval by the Swedish Ethical Review Authority in January 2020 (ID: 2019-05985; 2022-01117-02).</p><p><strong>Trial registration number: </strong>Registered at ClinicalTrials.gov (ID: NCT04230369).</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and 1-year outcomes of variable obstruction in participants with preserved spirometry: results from the ECOPD study in China.","authors":"Fan Wu, Haiqing Li, Zhishan Deng, Huajing Yang, Youlan Zheng, Ningning Zhao, Cuiqiong Dai, Jieqi Peng, Lifei Lu, Zihui Wang, Xiang Wen, Shan Xiao, Kunning Zhou, Xiaohui Wu, Gaoying Tang, Qi Wan, Ruiting Sun, Jiangyu Cui, Changli Yang, Shengtang Chen, Jianhui Huang, Shuqing Yu, Yumin Zhou, Pixin Ran","doi":"10.1136/bmjresp-2023-002210","DOIUrl":"10.1136/bmjresp-2023-002210","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the clinical features and longitudinal prognosis of variable obstruction, particularly among never smokers and different variable obstruction types. Therefore, we aimed to evaluate the clinical characteristics of the participants with variable obstruction and determine the relationship between variable obstruction and the development of chronic obstructive pulmonary disease (COPD) and the decline of lung function in a community-dwelling study of Chinese, especially among never smokers and different variable obstruction subtypes.</p><p><strong>Methods: </strong>Participants with preserved spirometry (postbronchodilator forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) ≥0.70) at baseline from the Early COPD cohort were included in our analysis. Participants with variable obstruction (prebronchodilator FEV₁/FVC <0.70) were compared with those without variable obstruction (prebronchodilator FEV₁/FVC ≥0.70). We performed subgroup analyses in never smokers, former and current smokers, and different variable obstruction types (postbronchodilator FVC <prebronchodilator FVC or postbronchodilator FVC ≥prebronchodilator FVC).</p><p><strong>Results: </strong>The final analysis included 1140 participants with preserved spirometry (169 in the variable obstruction group) at baseline. Participants with variable obstruction were older, had lower lung function and had greater severe emphysema and computed tomography-defined air trapping than participants without variable obstruction. Participants with variable obstruction had a significantly increased risk of incident spirometry-defined COPD (relative risk: 3.22, 95% confidence interval 2.23 to 4.64, p <0.001) than those without variable obstruction after adjustment for covariates. These findings remained consistent among both former and current smokers, never smokers, and different variable obstruction types. Additionally, participants with variable obstruction had a faster decline in postbronchodilator FEV₁/FVC (2.3±0.5%/year vs 0.9±0.4%/year, mean difference: 1.4 (95% confidence interval 0.5 to 2.3), p=0.002) than participants without variable obstruction after adjustment for covariates.</p><p><strong>Conclusions: </strong>The results of our study revealed that variable obstruction can identify individuals who are at risk for the development of COPD and accelerated postbronchodilator FEV₁/FVC decline in preserved spirometry.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing factors of sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review.","authors":"Stefanie Harding, Alan Richardson, Angela Glynn, Luke Hodgson","doi":"10.1136/bmjresp-2023-002261","DOIUrl":"10.1136/bmjresp-2023-002261","url":null,"abstract":"<p><strong>Background: </strong>People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy.</p><p><strong>Aim: </strong>This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD.</p><p><strong>Methods: </strong>A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed.</p><p><strong>Results: </strong>1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities.</p><p><strong>Conclusions: </strong>Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour.</p><p><strong>Prospero registration number: </strong>CRD42023387335.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIGIPREDICT: physiological, behavioural and environmental predictors of asthma attacks-a prospective observational study using digital markers and artificial intelligence-study protocol.","authors":"Amy Hai Yan Chan, Braden Te Ao, Christina Baggott, Alana Cavadino, Amber A Eikholt, Matire Harwood, Joanna Hikaka, Dianna Gibbs, Mariana Hudson, Farhaan Mirza, Muhammed Asif Naeem, Ruth Semprini, Catherina L Chang, Kevin C H Tsang, Syed Ahmar Shah, Aron Jeremiah, Binu Nisal Abeysinghe, Rajshri Roy, Clare Wall, Lisa Wood, Stuart Dalziel, Hilary Pinnock, Job F M van Boven, Partha Roop, Jeff Harrison","doi":"10.1136/bmjresp-2023-002275","DOIUrl":"10.1136/bmjresp-2023-002275","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma attacks are a leading cause of morbidity and mortality but are preventable in most if detected and treated promptly. However, the changes that occur physiologically and behaviourally in the days and weeks preceding an attack are not always recognised, highlighting a potential role for technology. The aim of this study 'DIGIPREDICT' is to identify early digital markers of asthma attacks using sensors embedded in smart devices including watches and inhalers, and leverage health and environmental datasets and artificial intelligence, to develop a risk prediction model to provide an early, personalised warning of asthma attacks.</p><p><strong>Methods and analysis: </strong>A prospective sample of 300 people, 12 years or older, with a history of a moderate or severe asthma attack in the last 12 months will be recruited in New Zealand. Each participant will be given a smart watch (to assess physiological measures such as heart and respiratory rate), peak flow meter, smart inhaler (to assess adherence and inhalation) and a cough monitoring application to use regularly over 6 months with fortnightly questionnaires on asthma control and well-being. Data on sociodemographics, asthma control, lung function, dietary intake, medical history and technology acceptance will be collected at baseline and at 6 months. Asthma attacks will be measured by self-report and confirmed with clinical records. The collected data, along with environmental data on weather and air quality, will be analysed using machine learning to develop a risk prediction model for asthma attacks.</p><p><strong>Ethics and dissemination: </strong>Ethical approval has been obtained from the New Zealand Health and Disability Ethics Committee (2023 FULL 13541). Enrolment began in August 2023. Results will be presented at local, national and international meetings, including dissemination via community groups, and submission for publication to peer-reviewed journals.</p><p><strong>Trial registration number: </strong>Australian New Zealand Clinical Trials Registry ACTRN12623000764639; Australian New Zealand Clinical Trials Registry.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients with COPD switching from multiple-inhaler to once-daily single-inhaler triple therapy in a real-world primary care setting in England: a retrospective pre-post cohort study.","authors":"Kieran J Rothnie, Robert P Wood, Alexandrosz Czira, Victoria L Banks, Lucinda J Camidge, Olivia K I Massey, Monica Seif, Chris Compton, Raj Sharma, David M G Halpin, Afisi S Ismaila, Claus F Vogelmeier","doi":"10.1136/bmjresp-2023-001890","DOIUrl":"10.1136/bmjresp-2023-001890","url":null,"abstract":"<p><strong>Background: </strong>Compared with multiple-inhaler triple therapy (MITT), single-inhaler triple therapy (SITT) with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) demonstrated improved lung function and meaningful improvements in chronic obstructive pulmonary disease (COPD) Assessment Test score. This real-world study compared the effectiveness of switching patients with COPD in England from MITT to once-daily SITT with FF/UMEC/VI by evaluating rates of COPD exacerbation, healthcare resource use (HCRU) and associated direct medical costs.</p><p><strong>Methods: </strong>Retrospective cohort pre-post study using linked primary care electronic health record and secondary care administrative datasets. Patients diagnosed with COPD at age ≥35 years, with smoking history, linkage to secondary care data and continuous GP registration for 12 months pre-switch and 6 months post-switch to FF/UMEC/VI were included. Index date was the first initiation of an FF/UMEC/VI prescription immediately following MITT use from 15 November 2017 to 30 September 2019. Baseline was 12 months prior to index, with outcomes assessed 6/12 months pre-switch and post-switch, and stratified by prior COPD exacerbation status.</p><p><strong>Results: </strong>We included 2533 patients (mean [SD] age: 71.1 [9.9] years; 52.1% male). In the 6 months post-switch, there were significant decreases in the proportion of patients experiencing ≥1 moderate-to-severe (36.2%-28.9%), moderate only (24.4%-19.8%) and severe only (15.4%-11.8%) COPD exacerbation (each, p<0.0001) compared with the 6 months pre-switch. As demonstrated by rate ratios, there were significant reductions in exacerbation rates of each severity overall (p<0.01) and among patients with prior exacerbations (p<0.0001). In the same period, there were significant decreases in the rate of each COPD-related HCRU and total COPD-related costs (-24.9%; p<0.0001).</p><p><strong>Conclusion: </strong>Patients with COPD switching from MITT to once-daily SITT with FF/UMEC/VI in a primary care setting had significantly fewer moderate and severe exacerbations, and lower COPD-related HCRU and costs, in the 6 months post-switch compared with the 6 months pre-switch.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping review of exposure questionnaires and surveys in interstitial lung disease.","authors":"Hayley Barnes, Seham Elmrayed, Christopher Michael Barber, Johanna Feary, Cathryn T Lee, Sheiphali Gandhi, Cheryl E Peters, Margaret L Salisbury, Kerri A Johannson","doi":"10.1136/bmjresp-2023-002155","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-002155","url":null,"abstract":"<p><strong>Background: </strong>Many interstitial lung diseases (ILDs) have clear causal relationships with environmental and occupational exposures. Exposure identification can assist with diagnosis, understanding disease pathogenesis, prognostication and prevention of disease progression and occurrence in others at risk. Despite the importance of exposure identification in ILD, there is no standardised assessment approach. Many questionnaires are in clinical and research use, yet their utility, applicability, relevance and performance characteristics are unknown.</p><p><strong>Objectives: </strong>This scoping review aimed to summarise the available evidence relating to ILD exposure assessment questionnaires, identify research gaps and inform the content for a future single evidence-based ILD questionnaire.</p><p><strong>Methods: </strong>A scoping review based on Arksey and O'Malley's methodological framework was conducted.</p><p><strong>Eligibility criteria: </strong>Any questionnaire that elicited exposures specific to ILD was included. A modified COSMIN Risk of Bias Framework was used to assess quality.</p><p><strong>Sources of evidence: </strong>Relevant articles were identified from MEDLINE and EMBASE up to 23 July 2023.</p><p><strong>Results: </strong>22 exposure questionnaires were identified, including 15 generally pertaining to ILD, along with several disease-specific questionnaires for hypersensitivity pneumonitis (n=4), chronic beryllium disease, sarcoidosis and silicosis (1 questionnaire each). For most questionnaires, quality was low, whereby the methods used to determine exposure inclusion and questionnaire validation were not reported or not performed. Collectively the questionnaires covered 158 unique exposures and at-risk occupations, most commonly birds, mould/water damage, wood dust, asbestos, farming, automotive mechanic and miners. Only five questionnaires also provided free-text fields, and 13 queried qualifiers such as temporality or respiratory protection.</p><p><strong>Conclusions: </strong>Designing a robust ILD-specific questionnaire should include an evidence-based and relevance-based approach to exposure derivation, with clinicians and patients involved in its development and tested to ensure relevance and feasibility.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}