Tag: Pulmonary

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Day-to-day measurement of patient-reported outcomes in exacerbations of chronic obstructive pulmonary disease.

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Day-to-day measurement of patient-reported outcomes in exacerbations of chronic obstructive pulmonary disease.

Int J Chron Obstruct Pulmon Dis. 2013;8:273-86

Authors: Kocks JW, van den Berg JW, Kerstjens HA, Uil SM, Vonk JM, de Jong YP, Tsiligianni IG, van der Molen T

Abstract
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major burden to patients and to society. Little is known about the possible role of day-to-day patient-reported outcomes during an exacerbation. This study aims to describe the day-to-day course of patient-reported health status during exacerbations of COPD and to assess its value in predicting clinical outcomes.
METHODS: Data from two randomized controlled COPD exacerbation trials (n = 210 and n = 45 patients) were used to describe both the feasibility of daily collection of and the day-to-day course of patient-reported outcomes during outpatient treatment or admission to hospital. In addition to clinical parameters, the BORG dyspnea score, the Clinical COPD Questionnaire (CCQ), and the St George’s Respiratory Questionnaire were used in Cox regression models to predict treatment failure, time to next exacerbation, and mortality in the hospital study.
RESULTS: All patient-reported outcomes showed a distinct pattern of improvement. In the multivariate models, absence of improvement in CCQ symptom score and impaired lung function were independent predictors of treatment failure. Health status and gender predicted time to next exacerbation. Five-year mortality was predicted by age, forced expiratory flow in one second % predicted, smoking status, and CCQ score. In outpatient management of exacerbations, health status was found to be less impaired than in hospitalized patients, while the rate and pattern of recovery was remarkably similar.
CONCLUSION: Daily health status measurements were found to predict treatment failure, which could help decision-making for patients hospitalized due to an exacerbation of COPD.

PMID: 23766644 [PubMed – in process]

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Is Clinical Judgment of Asthma Control Adequate?: A prospective survey in a tertiary hospital pulmonary clinic.

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Is Clinical Judgment of Asthma Control Adequate?: A prospective survey in a tertiary hospital pulmonary clinic.

Sultan Qaboos Univ Med J. 2013 Feb;13(1):63-8

Authors: Baddar S, Jayakrishnan B, Al-Rawas O, George J, Al-Zeedy K

Abstract
OBJECTIVES: Asthma control is often difficult to measure. The aim of this study was to compare physicians’ personal clinical assessments of asthma control with the Global Initiative for Asthma (GINA) scoring.
METHODS: Physicians in the adult pulmonary clinics of a tertiary hospital in Oman first documented their subjective judgment of asthma control on 157 consecutive patients. Immediately after that and in the same proforma, they selected the individual components from the GINA asthma control table as applicable to each patient.
RESULTS: The same classification of asthma control was achieved by physicians’ clinical judgment and GINA classification in 106 cases (67.5%). In the other 32.5% (n = 51), the degree of control by clinical judgment was one level higher than the GINA classification. The agreement was higher for the pulmonologists (72%) as compared to non-pulmonologists (47%; P = 0.009). Physicians classified 76 patients (48.4%) as well-controlled by clinical judgment compared to 48 (30.6%) using GINA criteria (P <0.001). Conversely, they classified 34 patients (21.7%) as uncontrolled as compared to 57 (36.3%) by GINA criteria (P <0.001). In the 28 patients who were clinically judged as well-controlled but, by GINA criteria, were only partially controlled, low peak expiratory flow rate (PEFR) (46.7%) and limitation of activity (21.4%) were the most frequent parameters for downgrading the level of control.
CONCLUSION: Using clinical judgment, physicians overestimated the level of asthma control and underestimated the uncontrolled disease. Since management decisions are based on the perceived level of control, this could potentially lead to under-treatment and therefore sub-optimal asthma control.

PMID: 23573384 [PubMed – in process]

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A Study to Evaluate the Efficacy and Safety of Umeclidinium Bromide/Vilanterol Compared With Fluticasone Propionate/Salmeterol Over 12 Weeks in Subjects With Chronic Obstructive Pulmonary Disease (COPD)

Condition:   Pulmonary Disease, Chronic Obstructive
Interventions:   Drug: Umeclidinium bromide/Vilanterol;   Drug: Placebo ACCUHALER/DISKUS;   Drug: Fluticasone propionate/Salmeterol;   Drug: Placebo NDPI
Sponsors:   GlaxoSmithKline;   GlaxoSmithKline
Not yet recruiting – verified April 2013

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High Risk of Pulmonary Embolism Seen in Severe Asthma – Monthly Prescribing Reference

High Risk of Pulmonary Embolism Seen in Severe Asthma
Monthly Prescribing Reference
(HealthDay News) – Patients with asthma are at higher risk of pulmonary embolism, particularly if the asthma is severe or they take oral corticosteroids, according to a study published online Dec. 20 in the European Respiratory Journal. Christof J …

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Asthma Associated With Pulmonary Embolism – Medscape


Medscape

Asthma Associated With Pulmonary Embolism
Medscape
Add asthma to the list of inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel disease, that are associated with activated coagulation and an increased risk for venous thromboembolic events (VTEs), the authors of a new study say.
Asthma Linked to Increased Risk of Dangerous Lung BlockageiVillage Entertainment
Severe asthma increases the risk of blood clots in lungWebMD.Boots.com
Asthma increases blood clot riskIrish Health
Everyday Health –Science Daily (press release)
all 13 news articles »

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