scholarly journals Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Author(s):  
Sven L. Klijn ◽  
Mickaël Hiligsmann ◽  
Silvia M. A. A. Evers ◽  
Miguel Román-Rodríguez ◽  
Thys van der Molen ◽  
...  
Author(s):  
Sven L. Klijn ◽  
Mickael Hiligsmann ◽  
Silvia M.A.A. Evers ◽  
Miguel Román-Rodríguez ◽  
Thys van der Molen ◽  
...  

2019 ◽  
Vol 9 (2) ◽  
pp. 170-179
Author(s):  
R Bhavana ◽  
R Suchithra ◽  
Manupati Thejaswini ◽  
Gundlapalli Harish Kumar ◽  
Dev Apoorva

Aim: A study on effectiveness and success factors of educational inhaler technique intervention in asthma and COPD. Objectives: To identify the percentage of common errors done by people who use inhalers. To identify the risk factors associated with asthma and COPD. Method: Data was collected from the subject’s face to face interview in a community setup and the lung capacities were measured using spirometer and peak flow meter; the values were noted and the subjects were asked to demonstrate their inhaler technique using placebo inhalers; numbers of correct and incorrect steps were noted. After a period of one month; the subjects were taken to follow up and measured the lung capacities and checked the inhaler steps; number of correct and incorrect steps were noted. Results: A total of 572 samples were collected and 500 were followed up, in which 300 had Asthma and 200 had COPD. Out of which 189 were female and 311 were male. Low education level was the single most important factor leading to incorrect technique. Formal training resulted in a statistically significant increase in the percentage of correct techniques for all the devices. For pMDI (54.01% vs. 91.03%, *p=0.005 before & after training respectively). For pMDI+Spacer (52.75% vs. 94.85%, *p=0.007 before & after training respectively). For Accuhaler (54.07% vs. 91.27%, *p=0.017 before & after training respectively). For Rotahaler (63.94 vs. 98.64%. *p=0.029 before & after training respectively). For Nebuliser (56.97% vs. 91.88%, *p=0.001 before & after training respectively. Conclusion: Proper education to patients on correct usage may not only improve control of the symptoms of the disease but might also allow dose reduction in long term. The number of subjects doing correct steps gradually increased after the pharmacist led intervention. Thus, proper counselling for the inhaler use in patients must be encouraged as it is directly linked to the quality of life of patient. Keywords: Asthma and COPD control inhaler devices, inhaler technique, pharmacist intervention, inhaler education.


2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.


2020 ◽  
Vol 17 (6) ◽  
pp. 732-741
Author(s):  
Elaine Marron ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Zena Moore ◽  
Bridget Murray ◽  
...  

2021 ◽  
Author(s):  
Niamh Kelly ◽  
Lewis Winning ◽  
Christopher Irwin ◽  
Fionnuala Lundy ◽  
Dermot Linden ◽  
...  

Abstract BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal health and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations. MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life and hospitalisation. Studies were assessed for eligibility and quality by two assessors independently.Results Searches identified 532 records and 8 met the inclusion criteria. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores with exacerbation but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations and quality of life in COPD patients. The evidence is limited by high risk of bias suggesting need for well-designed and adequately powered randomised control trials.The PROSPERO registration number CRD42020180328


2022 ◽  
Vol 207 ◽  
pp. 108452
Author(s):  
Linyan Chen ◽  
Albert P.C. Chan ◽  
Emmanuel K. Owusu ◽  
Amos Darko ◽  
Xin Gao

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dulani Jayasuriya Daluwathumullagamage

Purpose The business model of monoline insurers is to guarantee payments of debt issues in case of defaults by the issuer. Although sparse attention is given to monolines in literature, they play an important role in enabling municipalities and firms in refinancing. This study aims to conduct a systematic review of 181 articles from 1990 to 2020 from 23,130 records and a case study on the key monoline insurers. Key failure, success factors and demand for future monoline insurance are identified. Finally, the study explores monolines’ potential during COVID-19 and develops a framework for monoline governance and regulation. Design/methodology/approach The study follows Briner and Denyer and Moher et al. to implement the systematic review. The methodology involves ascertaining the motivation behind the review, and formulating research questions; aggregating relevant prior literature from scientific databases, conducting quality assessment and synthesising the data; and conducting extensive analysis for framework development. Case study methodology foundation phase focuses on understanding the research philosophy. The second phase involves documenting the procedures involved. The final phase involves collecting the relevant quantitative and qualitative material. In addition, collecting empirical data from numerous sources allows triangulation. Findings The review results of 181 articles from 1990 to 2020 show that peak article counts occur in 2010 and 2013 (nine academic studies) and in 2008 and 2010 (six industry studies). Over- and under-explored domains happen to be bond pricing (86 academic studies) and bond markets (36 industry studies) and corporate bonds (19 academic studies), respectively. The study highlights failure factors such as adverse selection, premiums mispricings, inadequate capital and regulation, untimely downgrades and governance issues; and identifies success factors such as conservative underwriting, early financing, competitor business acquisitions and obtaining put-back claims. Potential during COVID-19 is discussed and a monoline governance framework is developed. Research limitations/implications Search and selection criteria distortions may lead to sample selection bias in systematic reviews. Issue is addressed by using different permutations of the search key words to refine the search criteria. Reference list of collected final sample of articles are perused to identify additional articles. It is difficult to obtain verifiable empirical data on the bond/monoline insurers or their insured products, especially for the structured finance sector. Most of the information available on data stream and firm’s quarterly financial reports for publicly traded monoline/bond insurers and credit rating reports are included to overcome this issue. Practical implications Demand for bond/monoline insurance still persists even in the USA. Although borrowing costs are low, obtaining bank loans would be challenging for municipalities and corporates with increased risks. Especially, given worldwide government stimulus on wages, most municipalities would possess reduced budgets for public finance. Monoline insurance can play a key role in financing such projects. Thus, it is important to understand their unique traditional and transformed business model and applicability during and post-COVID-19. Given the near extinction of bond/monoline insurers during the 2008 global financial crisis (GFC), an adequate framework for bond/monoline insurers as developed in this study is key for future business continuity. Social implications There is significant interest, especially, from the industry on monolines as identified in our systematic review. Monoline insurance has major effects on taxpayers, government policies and bond investors. They aid in financing public finance projects that have significant societal impact. This study contributes by filling existing gaps in the literature, especially, from a behavioural, ethical and social perspective of the monolines, regulators, other stakeholders and new entrants to the industry during COVID-19. This study links prior finance theories to the impact of bond/monoline insurer’s during the 2008 GFC and their stakeholders involved that has societal implications. Originality/value This study can be differentiated from prior research on monoline insurers as follows: The study identifies, gaps, similarities, trends between prior academic and industry literature and develop a bond/monoline governance framework; identifies key failure and success factors during the 2008 GFC crisis to develop the governance framework and identify monolines’ potential during COVID-19; as opposed to most prior literature that only focus on one (Drake and Neal, 2011 analyse MBIA) or two key bond/monoline insurers, this study focuses on five key bond/monoline insurers in detail and all other key insurers as well in the empirical analysis section.


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