The Economic Burden of Pulmonary Hypertension Among Patients with Chronic Obstructive Pulmonary Disease and Interstitial Lung Disease

Author(s):  
A. Hemnes ◽  
C.E. Ventetuolo ◽  
S. Manaker ◽  
J. Noone ◽  
R. Howden ◽  
...  
2021 ◽  
pp. 204589402110056
Author(s):  
Hillary Dubrock ◽  
Steven Nathan ◽  
Bryce B. Reeve ◽  
Nicholas Kolaitis ◽  
Stephen C. Mathai ◽  
...  

Pulmonary hypertension (PH) resulting from chronic lung disease such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) is categorized by the World Health Organization (WHO) as Group 3 PH. To identify the symptoms and impacts of WHO Group 3 PH and to capture data related to the patient experience of this disease, qualitative research interviews were undertaken with 3 clinical experts and with 14 individuals with PH secondary to COPD or ILD. Shortness of breath, fatigue, cough, and swelling were the most frequently reported symptoms of PH due to COPD or ILD, and shortness of breath was further identified as the single most bothersome symptom for most patients (71.4%). Interview participants also described experiencing a number of impacts related to PH and PH symptoms, including limitations in the ability to perform activities of daily living and impacts on physical functioning, family life, and social life as well as emotional impacts, which included frustration, depression, anxiety, isolation, and sadness. Results of these qualitative interviews offer an understanding of the patient experience of PH due to COPD or ILD, including insight into the symptoms and impacts that are most important to patients in this population. As such, these results may help guide priorities in clinical treatment and assist researchers in their selection of patient-reported outcome measures for clinical trials in patients with PH due to COPD or ILD.


Author(s):  
Joon Young Choi ◽  
Jin Woo Song ◽  
Chin Kook Rhee

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents may be beneficial in patients with CPFE, but further studies are needed.


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