scholarly journals Breathlessness and opioid prescribing in COPD in general practice: a cross-sectional, observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 00299-2019
Author(s):  
David C. Currow ◽  
Miriam J. Johnson ◽  
Allan Pollack ◽  
Diana H. Ferreira ◽  
Slavica Kochovska ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Pain Patient ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Obstructive Pulmonary Disease ◽  
Health Database

Chronic breathlessness is a disabling syndrome, prevalent in people with advanced chronic obstructive pulmonary disease (COPD). Regular, low-dose, oral sustained-release morphine is approved in Australia to reduce symptomatic chronic breathlessness. We aimed to determine the current prescribing patterns of opioids for chronic breathlessness in COPD in Australian general practice and to define any associated patient and practitioner characteristics.Five years (2011 to 2016) of the Bettering the Evaluation and Care of Health database, an Australian national, continual, cross-sectional study of clinical care in general practice were used. The database included 100 consecutive clinical encounters from almost 1000 general practitioners annually (n=488 100 encounters). Descriptive analyses with subsequent regression models were generated.Breathlessness as a patient-defined reason for encounter was identified in 621 of 4522 encounters where COPD was managed. Opioids were prescribed in 309 of 4522 encounters where COPD was managed (6.8%; (95% CI) 6.1–7.6), of which only 17 were prescribed for breathlessness, and the rest for other conditions almost entirely related to pain. Patient age (45–64 years versus age 80+ years, OR 1.68; 1.19–2.36), Commonwealth Concession Card holders (OR 1.70; 1.23–2.34) and socioeconomic disadvantage (OR 1.30; 1.01–1.68) were associated with increased likelihood of opioid prescription at COPD encounters. The rate of opioid prescriptions rose over the 5 years of study.In primary care encounters for COPD, opioids were prescribed in 6.8% of cases, but almost never for breathlessness. These data create a baseline against which to compare changes in prescribing as the treatment of chronic breathlessness evolves.

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

Clinical and Quality of Life Differences in Patients with COPD With and Without a Background of Hospitalization in the Last Year

2021 ◽  
Vol 16 (4) ◽  
pp. 228-233
Author(s):  
Jhonatan Betancourt-Peña ◽  
Juan Carlos Ávila-Valencia ◽  
Jorge Karim Assis ◽  
David Alejandro Escobar-Vidal
Keyword(s):  
Quality Of Life ◽  
Survival Rates ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Upward Trend ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Lower Socioeconomic ◽  
Causes Of Mortality

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death worldwide. An upward trend is estimated by 2030. One of the causes of mortality is the exacerbations of symptoms that result in hospitalizations. These hospitalizations reduce the quality of life, limit performance in daily life, and increase the costs for the health system and the patient. Objective: This study aimed to determine the differences between hospitalized and non-hospitalized patients with a medical diagnosis of COPD, considering some sociodemographic and clinical variables, and survival rates. Methods: A cross-sectional study was conducted, which included patients diagnosed with COPD who initiated pulmonary rehabilitation (PR) from January to September 2018. The patients were divided into two groups: patients with one or more exacerbations that led to the hospitalization (COPD-H) and patients without hospitalizations in the last year (COPD-NH). Results: There were 128 participants (78 males and 50 females), with a mean age of 71.10±(9.34) in the COPD-H group and 71.30±(8.91) in the COPD-NH group. When comparing both groups, COPD-NH had a higher socioeconomic status (p=0.041), reporting a higher FEV1 44.71± (14.97), p=0.047, and comorbidities according to the COTE index (p<0.001). Conclusion: The patients with the highest number of hospitalizations belonged to a lower socioeconomic stratum and had a higher number of comorbidities. Therefore, it is necessary to identify these factors at the beginning of PR.

Association between Chronic Obstructive Pulmonary Disease and Peripheral Arterial Disease in Construction Workers-A Cross-Sectional Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2989-2994
Author(s):  
U. Sivakumar ◽  
Rinku Garg ◽  
Sunita Nighute
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Peripheral Arterial Disease ◽  
Pulmonary Disease ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Arterial

Objective: COPD has been recognized not only as a lung but also a systemic disease. Smoking is a major cause of COPD, cardiovascular disease, stroke and peripheral arterial disease (PAD). Methods: This was a cross-sectional study conducted at the Department of Physiology, Santosh Medical College diagnosed with COPD using Spirometry was recruited for the study with a sample size of 130 patients. Results: Of the 130 participants, the mean age was 51.73 years of all COPD patients. Thirty-seven (28.46%) were diagnosed to have PAD. Twenty-five patients (19.23%) were overweight, 10 (7.69%) were obese. All the patients included in the study had history of smoking, including current (n= 67, 51.5%) and former (n= 35, 26.9%) smokers. There was no patient with severe respiratory failure in our study. The most common cardiovascular co-morbidity was hypertension (n= 67, 51.5%), followed by diabetes mellitus (n =28, 21.5%), and dyslipidaemia (n= 35, 26.92%). PAD seen in different stages of COPD stage I –IV were 2.94%, 55.88%, 61.76%, 20.58% respectively. Conclusion: The diagnosis of peripheral arterial disease in COPD is important because this is an entity that limits the patient’s physical activity and impairs their quality of life. Lung function was not associated with PAD in patients with COPD. Abnormal ABI results were associated with a higher prevalence of risk factors and more severe lung disease. Keywords: Peripheral Arterial Disease, Smoking, Chronic Obstructive Pulmonary Disease.

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