scholarly journals Effect of particulate matter exposure on patients with COPD and risk reduction through behavioural interventions: the protocol of a prospective panel study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039394
Author(s):  
Shinhee Park ◽  
Seung Won Ra ◽  
Sung Yoon Kang ◽  
Hwan-Cheol Kim ◽  
Sei Won Lee
Keyword(s):  
Particulate Matter ◽  
Panel Study ◽  
Intervention Group ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Time Activity ◽  
The Individual ◽  
Behaviour Score ◽  
The Impact

IntroductionPatients with chronic obstructive pulmonary disease (COPD) are vulnerable to particulate matter (PM) exposure which can increase acute exacerbations and hospitalisation. Interventions to avoid PM exposure are important but evidence-based guidance is lacking. This study aims to assess the impact of PM on lung function, quality of life and exacerbations in patients with COPD using a panel design study; it will also provide evidence for interventional measures to reduce harm from PM exposure.Methods and analysisA prospective panel study of patients with COPD aged ≥40 years will be conducted. Patients will be required to have a forced expiratory volume in one second <80% of the predicted value at enrolment. A total of 120 patients from three different regions will be enrolled, 60 from the metropolitan area, 30 from an industrialised area and 30 from a clean rural area. Clinical outcomes will be assessed through COPD assessment test scores, the St. George’s Respiratory Questionnaire for patients with COPD and pulmonary function testing. Indoor and outdoor PM in the patients’ environments will be measured using gravimetric and light scattering platforms. To estimate the individual dose of PM exposure, a time–activity diary, Geographic Information System and land use regression model will be combined in every season for 1 year. The correlation between PM exposure and the health status of patients with COPD will be evaluated. In addition, 40 patients with the lowest score of life behaviour score to reduce environmental PM exposure will be randomised to a control or intervention group, who will receive in-depth education on risk-reducing behaviours.Ethics and disseminationThis study was approved by the Institutional Review Board of each site. The participants received comprehensive information and provided informed consent. The result of this study will be discussed in the form of conference presentations and peer-reviewed publications.Trial registration numberNCT04020237.

Pharmacist-Led Transition of Care Pilot Targeting Older People After Emergency Department Discharge

2020 ◽  
Vol 35 (6) ◽  
pp. 273-282
Author(s):  
Scott M. Pearson ◽  
Anushka Tandon ◽  
Danielle R. Fixen ◽  
Sunny A. Linnebur ◽  
Gretchen M. Orosz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Primary Outcome ◽  
Transitional Care ◽  
Intervention Group ◽  
Chronic Obstructive ◽  
P Value ◽  
Historical Cohort ◽  
Obstructive Pulmonary Disease ◽  
The Impact

OBJECTIVE: To evaluate the impact of a pharmacist-led transitional care intervention targeting high-risk older people after an emergency department (ED) visit.<br/> DESIGN: Retrospective cohort study of older people with ED visits prior to and during a pharmacist-led intervention.<br/> SETTING: Patients receiving primary care from the University of Colorado Health Seniors Clinic.<br/> PARTICIPANTS: The intervention cohort comprised 170 patients with an ED visit between August 18, 2018, and February 19, 2019, and the historical cohort included 166 patients with an ED visit between August 18, 2017, and February 19, 2018. All included patients either had a historical diagnosis of heart failure or chronic obstructive pulmonary disease, or they had an additional ED visit in the previous six months.<br/> INTERVENTIONS: The pilot intervention involved postED discharge telephonic outreach and assessment by a clinical pharmacist, with triaging to other staff if necessary.<br/> MAIN OUTCOME MEASURE: The primary outcome was the proportion of patients with at least one repeat ED visit, hospitalization, or death within 30 days of ED discharge. Outcome rates were also assessed at 90 days postdischarge.<br/> RESULTS: The primary outcome occurred in 21% of the historical cohort and 25% of the intervention cohort (adjusted P-value = 0.48). The incidence of the composite outcome within 90 days of ED discharge was 43% in the historical group compared with 38% in the intervention group (adjusted P-value = 0.29).<br/> CONCLUSION: A pharmacist-led telephonic intervention pilot targeting older people did not appear to have a significant effect on the composite of repeat ED visit, hospitalization, or death within 30 or 90 days of ED discharge. A limited sample size may hinder the ability to make definitive conclusions based on these findings.

scholarly journals Obesity as a susceptibility factor to indoor particulate matter health effects in COPD

2015 ◽  
Vol 45 (5) ◽  
pp. 1248-1257 ◽  
Author(s):  
Meredith C. McCormack ◽  
Andrew J. Belli ◽  
Deepak A. Kaji ◽  
Elizabeth C. Matsui ◽  
Emily P. Brigham ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Particulate Matter ◽  
Pulmonary Disease ◽  
Rescue Medication ◽  
Medication Use ◽  
Disease Stage ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Indoor Particulate Matter ◽  
The Impact

Our goal was to investigate whether obesity increases susceptibility to the adverse effects of indoor particulate matter on respiratory morbidity among individuals with chronic obstructive pulmonary disease (COPD).Participants with COPD were studied at baseline, 3 and 6 months. Obesity was defined as a body mass index ≥30 kg·m−2. At each time point, indoor air was sampled for 5–7 days and particulate matter (PM) with an aerodynamic size ≤2.5 μm (PM2.5) and 2.5–10 μm (PM2.5–10) was measured. Respiratory symptoms, health status, rescue medication use, exacerbations, blood biomarkers and exhaled nitric oxide were assessed simultaneously.Of the 84 participants enrolled, 56% were obese and all were former smokers with moderate-to-severe COPD. Obese participants tended to have less severe disease as assessed by Global Initiative for Chronic Obstructive Pulmonary Disease stage and fewer pack-years of smoking. There was evidence that obesity modified the effects of indoor PM on COPD respiratory outcomes. Increases in PM2.5 and PM2.5–10 were associated with greater increases in nocturnal symptoms, dyspnoea and rescue medication use among obese versus non-obese participants. The impact of indoor PM on exacerbations, respiratory status and wheeze also tended to be greater among obese versus non-obese participants, as were differences in airway and systemic inflammatory responses to indoor PM.We found evidence that obesity was associated with exaggerated responses to indoor fine and coarse PM exposure among individuals with COPD.

scholarly journals Impact of feedback on physical activity levels of individuals with chronic obstructive pulmonary disease during pulmonary rehabilitation

2014 ◽  
Vol 11 (4) ◽  
pp. 191-198 ◽  
Author(s):  
Joana Cruz ◽  
Dina Brooks ◽  
Alda Marques
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Activity Monitors ◽  
Standing Time ◽  
The Impact

This study aimed at investigating whether providing feedback on physical activity (PA) levels to patients with chronic obstructive pulmonary disease (COPD) is feasible and enhances daily PA during pulmonary rehabilitation (PR). Patients with COPD participated in a 12-week PR program. Daily PA was measured using activity monitors on weeks 1, 7, and 12, and feedback was given in the following weeks on the number of steps, time spent in sedentary, light, and moderate-to-vigorous intensity activities, and time spent standing, sitting, and lying. Compliance with PA monitoring was collected. Two focus groups were conducted to obtain patients’ perspectives on the use of activity monitors and on the feedback given. Differences in PA data were also assessed. Sixteen patients (65.63 ± 10.57 years; forced expiratory volume in one second (FEV1) 70.31 ± 22.74% predicted) completed the study. From those, only eleven participants used the activity monitors during all monitoring days. Participants identified several problems regarding the use of activity monitors and monitoring duration. Daily steps (  p = 0.026) and standing time (  p = 0.030) were improved from week 1 to week 7; however, the former declined from week 7 to week 12. Findings suggest that using feedback to improve PA during PR is feasible and results in improved daily steps and standing time on week 7. The subsequent decline suggests that additional strategies may be needed to stimulate/maintain PA improvements. Further research with more robust designs is needed to investigate the impact of feedback on patients’ daily PA.

scholarly journals Clinical observation of the use of portable pulmonary function test trainer in patients with stable COPD

2019 ◽  
Vol 02 (04) ◽  
pp. 185-191
Author(s):  
Yuhua Wu ◽  
Jian Zhou ◽  
Mengyu Ma ◽  
Jing Xie ◽  
Ahong Wang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Daily Living ◽  
Comparison Group ◽  
Psychological Symptoms ◽  
Social Activity ◽  
Intervention Group ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Clinical Effects ◽  
Obstructive Pulmonary Disease

Objective: To investigate the clinical effects of the use of portable pulmonary function tester in patients with stable Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 80 patients with stable COPD were enrolled in our hospital from March 2018 to March 2019. They were divided into two groups according to different treatment methods. The comparison group was used for routine pulmonary function training, and the intervention group was trained for Portable Pulmonary Function Training and Test Device (PPFTTD). Comparison was made of forced expiratory volume in one second/forced vital capacity (FEV1/FVC), measured/predicted value of the first second forced expiratory volume (FEV1 measured/predicted value), measured/predicted value of maximal voluntary ventilation per minute between the two groups. Quality of life (QOL) scores such as daily living ability, social activity, depressive psychological symptoms, and anxiety psychological symptoms were measured. Results: The FEV1/FVC value, measured/predicted value of FEV1 and MVV of intervention group were higher than those in the comparison group ([Formula: see text]). QOL scores, such as daily living ability, social activity, depression psychological symptoms, and anxiety psychological symptoms in the intervention group, were lower than those in the comparison group ([Formula: see text]). Conclusion: In the treatment of stable COPD, the use of portable pulmonary function tester is significant, and it should be widely promoted and applied in clinical practice.

scholarly journals Obesity Impact on Respiratory Function

2021 ◽  
Vol 18 (1) ◽  
pp. 41-58
Author(s):  
Anca Hâncu ◽  
Florin Mihălţan
Keyword(s):  
Pulmonary Function ◽  
Respiratory Function ◽  
Healthy Lifestyle ◽  
Respiratory Health ◽  
Forced Expiratory Volume ◽  
Overweight And Obesity ◽  
Chronic Obstructive ◽  
Dietary Recommendations ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Abstract Not so much emphasize in literature and studies, obesity consequences on respiratory function may influence chronic obstructive pulmonary disease COPD and asthma, triggering important healthcare issues. Pulmonary function is a mortality predictor. The largest populational study European Community Respiratory Health Survey shows the impact of overweight and obesity on pulmonary function by decreasing forced expiratory volume in first second FEV1 and forced vital capacity FVC. By the contrary, weight loss is decreasing both. Inflammatory and mechanical mechanisms should be considered in lung function impairment, as a consequence of obesity. Important aspect, lifestyle, will consider tobacco, physical activity, diet. Adopting a healthy lifestyle with a Mediterranean Diet MD will preserve a good pulmonary function on long term. We detailed below specific dietary recommendations, favorable nutrients or foods to be avoided. In conclusion comprehensive lifestyle interventions should become populational based interventions for a better prevention for pulmonary diseases and NCD’s and finally for a better health status.

scholarly journals Influence of Particulate Matter during Seasonal Smog on Quality of Life and Lung Function in Patients with Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 16 (1) ◽  
pp. 106 ◽  
Author(s):  
Chaicharn Pothirat ◽  
Warawut Chaiwong ◽  
Chalerm Liwsrisakun ◽  
Chaiwat Bumroongkit ◽  
Athavudh Deesomchok ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Particulate Matter ◽  
Lung Function ◽  
Chronic Obstructive ◽  
Short Term ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Impact

The impact of outdoor air pollution on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients, as measured by the COPD assessment test (CAT) questionnaire, is limited. The aim of this study was to determine the impact of a short-term increase in outdoor particulate matter in which the particles are less than 10 microns in diameter (PM10) during a seasonal smog period on QoL, symptoms, and lung function in COPD patients. This prospective observational study was conducted at Chiang Dao Hospital, Chiang Mai, Thailand between March and August 2016. Measurement of QoL, severity of dyspnea, forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1) were performed at both high and low PM10 periods. Fifty-nine patients met the inclusion criteria for enrollment into the study, with the mean age being 71.5 ± 8.0 years. Total CAT score, but not mMRC score, was statistically higher during the high PM10 period. The two lung function parameters, FVC and FEV1, were significantly lower at the high PM10 compared to the low PM10 period. We concluded that exposure to PM10 during the seasonal smog period resulted in short-term negative impact on the quality of life and lung function in COPD patients.

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