ADAPT (After DischArge Pulmonary Telehealth): home telemonitoring follow-up for chronic obstructive pulmonary disease (COPD) patients post hospital discharge

2013 ◽  
Author(s):  
Keir Lewis
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Discharge ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Home Telemonitoring ◽  
Copd Patients

scholarly journals Chronic obstructive pulmonary disease patients electronic register analysis: the effectiveness of patient’s dynamic follow up and evaluation of treatment program

2019 ◽  
Vol 91 (1) ◽  
pp. 78-83
Author(s):  
V Ju Mishlanov ◽  
I V Shubin ◽  
K N Bekker ◽  
A V Katkova ◽  
E P Koshurnikova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Inhaled Corticosteroid ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Register Analysis ◽  
Long Acting

In the last few years new informatics methods were implemented in medicine and allowed to create big data including individual clinical markers of every patient. It is suggested that clinical electronic patient’s register analysis will present accurate information about different treatment programs effectiveness, including those whose effectiveness is not still proved today. The aim of the study. To estimate the effectiveness of clinical patients register implementation as well as to analyze different treatment and prophylactic programs on chronic obstructive pulmonary disease (COPD) patients’ structure. Materials and methods. The COPD patient’s register consists of 4257 cases. Spirometrical data were evaluated. Dynamic follow was performed on 567 COPD patients. Bronchodilator’s therapy was estimated as well as combined inhaled corticosteroid/ long acting β2-agonist medications and vaccination against pneumococcal infection. Results. Computer program “Electronic polyclinic” proposed by the authors of this article is effective in precision of diagnostic decision making in cohort study, dynamic follow up after clinical symptoms, evaluation of instrumental and laboratory results, prophylactics and treatment effectiveness, “clinical patients registers” automatic formation using syndrome or nosological principle, checking the COPD patients in the group of those with bronchial obstruction. Conclusion. Positive effects of long-acting bronchodilator treatment on COPD exacerbation decreasing and more expressed effect of inhaled corticosteroid/ long acting β2-agonists were confirmed. More interesting result was influence of vaccination against pneumococcal infection PCV13 (polyvalent conjugated vaccine) on exacerbation frequency and dyspnea severity.

Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease

Respiration ◽  
2020 ◽  
pp. 1-11
Author(s):  
Eun Kyung Kim ◽  
Dave Singh ◽  
Joo Hun Park ◽  
Yong Bum Park ◽  
Seung-Il Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Longitudinal Change ◽  
Chronic Obstructive ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

<b><i>Background:</i></b> Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. <b><i>Objective:</i></b> We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. <b><i>Methods:</i></b> This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. <b><i>Results:</i></b> This analysis included 537 COPD patients (mean age = 67.4 ± 7.9 years, male = 97.0%, mean BMI = 23.0 ± 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (<i>n</i> = 37), 68.9% (<i>n</i> = 370), and 24.2% (<i>n</i> = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV<sub>1</sub>) (<i>p</i> &#x3c; 0.001), shorter 6-minute walk distance (<i>p</i> &#x3c; 0.001), higher modified Medical Research Council score (<i>p</i> = 0.002), higher St. George Respiratory Questionnaire score (<i>p</i> &#x3c; 0.001), higher emphysema index (<i>p</i> &#x3c; 0.001) and air-trapping index (<i>p</i> &#x3c; 0.001), and more frequent (<i>p</i> &#x3c; 0.001) and severe exacerbations (<i>p</i> = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, <i>p</i> = 0.038) and the descent of BMI group (HR = 3.167, <i>p</i> = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV<sub>1</sub>, and severe exacerbations were significantly associated with mortality. <b><i>Conclusions:</i></b> This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed.

scholarly journals Impact of tobacco-related chronic obstructive pulmonary disease on developmental trajectories of comorbidities in the Taiwan population

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Te-Wei Ho ◽  
Yi-Ju Tsai ◽  
Chun-Ta Huang ◽  
Angela Shin-Yu Lien ◽  
Feipei Lai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Developmental Trajectories ◽  
Chronic Obstructive ◽  
Control Groups ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control ◽  
The Impact

AbstractComorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017–2.198], malignancy (IRR 2.397; 95% CI 1.408–4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612–5.318), heart failure (IRR 2.531; 95% CI 1.502–4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176–3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.

scholarly journals Quantitative Assessment the Longitudinal Changes of Pulmonary Vascular Counts in Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Sang Won Park ◽  
Myoung-Nam Lim ◽  
Woo Jin Kim ◽  
So Hyeon Bak
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Longitudinal Changes ◽  
Severe Emphysema ◽  
Copd Patients

Abstract BackgroundChest computed tomography(CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. However, there are few studies of changes in vascular during longitudinal follow-up in COPD patients. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.Materials and MethodsA total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.ResultsNtotal/LSA and N<5mm/LSA changed from 1.16±0.27 to 0.87±0.2 and from 1.02±0.22 to 0.78±0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39±0.21 to 0.74±0.17 and from 1.18±0.19 to 0.67±0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r=-0.738, -0.529) and N<5mm /LSA (r=-0.729, -0.497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5mm/LSA (r=0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5mm/LSA was (-0.032, -0.023) and (-0.027) in normal and SAD, respectively.ConclusionsQuantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.Trial registrationWe obtained the written informed consent from all participants in this study and the approval for all processes by our institution Institutional Review Board.

scholarly journals Effectiveness of pneumococcal vaccine in patients with chronic obstructive pulmonary disease (COPD)

2018 ◽  
Vol 6 (11) ◽  
pp. 3698
Author(s):  
Thitta Mohanty ◽  
Mahismita Patro ◽  
Jyotirmaya Sahoo ◽  
Bijaya Kumar Meher ◽  
Manoranjan Pattnaik ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pneumococcal Vaccine ◽  
Controlled Trial ◽  
Airflow Obstruction ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Pneumococcal infections are frequent cause chronic obstructive pulmonary disease (COPD) exacerbations and though various guidelines recommend the use of pneumococcal vaccines routinely to COPD patients to prevent exacerbations, the data regarding the effectiveness of this vaccine is limited and contradictory. Aims and objectives was to compare the frequency of exacerbations in patients of COPD before and after administration of pneumococcal vaccine and to find out the frequency of exacerbations in patients of COPD who are vaccinated against those who are not vaccinated as well as to study the effectiveness of pneumococcal vaccine will be analysed in respect to age, sex, Body mass index (BMI), severity of disease and other co-morbidity.Methods: This was a randomized non-placebo controlled trial, conducted from September 2013 to August 2015 including total of 150 patients divided into two groups: cases and controls. The cases were administered PPV23 along with specific medication and were followed up at intervals of 3months. Exacerbations were identified based on ANTHONISEN’S criteria. Number of exacerbations in each follow-up was recorded. The data from both the groups were analysed statistically.Results: After 1 year of follow up, there was significant reduction in mean number of exacerbations (p value <0.0001) in patients with COPD in vaccinated group. PPV23 was more effective in patients with COPD of less than 65 years of age and with severe and/or very severe airflow obstruction and also in patients with lower BMI (≤21kg/m2), females and with co-morbidities.Conclusions: This is an important strategy to prevent the repeated exacerbations in COPD patients particularly in severe and very severe disease groups and we support the recommendation that pneumococcal vaccine should be administered to these patients.

scholarly journals Risk of Chronic Obstructive Pulmonary Disease Exacerbation in Patients Who Use Methotrexate—A Nationwide Study of 58,580 Outpatients

Biomedicines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 604
Author(s):  
Christina Marisa Bergsøe ◽  
Pradeesh Sivapalan ◽  
Mohamad Isam Saeed ◽  
Josefin Eklöf ◽  
Zaigham Saghir ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Propensity Score ◽  
Pulmonary Disease ◽  
Sensitivity Analyses ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Matched Study

Patients with severe chronic obstructive pulmonary disease (COPD) experience frequent acute exacerbations and require repeated courses of corticosteroid therapy, which may lead to adverse effects. Methotrexate (MTX) has anti-inflammatory properties. The objective of this study was to describe the risk of COPD exacerbation in patients exposed to MTX. In this nationwide cohort study of 58,580 COPD outpatients, we compared the risk of hospitalization-requiring COPD exacerbation or death within 180 days in MTX vs. non-MTX users in a propensity-score matched study population as well as an unmatched cohort, in which we adjusted for confounders. The use of MTX was associated with a reduction in risk of COPD exacerbation in the propensity-score matched population at 180 days follow-up (HR 0.66, CI 0.66–0.66, p < 0.001). Similar results were shown in our sensitivity analyses at 180-day follow-up on unmatched population and 365-day follow-up on matched and unmatched population (HR 0.76 CI 0.59–0.99, HR 0.81 CI 0.81–0.82 and HR 0.92 CI 0.76–1.11, respectively). MTX was associated with a lower risk of COPD exacerbation within the first six months after study entry. The finding seems biologically plausible and could potentially be a part of the management of COPD patients with many exacerbations.

Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol

2010 ◽  
Vol 66 (6) ◽  
pp. 1365-1370 ◽  
Author(s):  
Eva Abad-Corpa ◽  
Andrés Carrillo-Alcaraz ◽  
Tania Royo-Morales ◽  
Maria Carmen Pérez-García ◽  
Juan José Rodríguez-Mondejar ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Hospital Discharge ◽  
Chronic Obstructive ◽  
Research Protocol ◽  
Obstructive Pulmonary Disease ◽  
Disease Research

scholarly journals Impact of bronchiectasis on long-term survival in patients with acute exacerbation of chronic obstructive pulmonary disease

2019 ◽  
Author(s):  
Ying Zhang ◽  
Shu Zhang ◽  
Yan-Li Gao ◽  
Zhen Wang ◽  
Xiao-Ning Bu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Medical Record ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Term Survival ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Background Only few studies have reported the association between bronchiectasis and mortality in patients with Chronic Obstructive Pulmonary Disease (COPD) and the results were controversial. This study aimed at assessing the prognostic influence of bronchiectasis on COPD patients and comparing differences of prognostic influence of different types of bronchiectasis on COPD patients. Patients and methods This study enrolled patients hospitalized for COPD exacerbation between 2013 and 2014. Bronchiectasis was identified on high-resolution computed tomography (HRCT) within 2 years prior to this hospitalization due to COPD exacerbation and Smith score was used to determine the extent of bronchiectasis. Clinical data were obtained from electronic inpatient medical record. The survival data were obtained through telephone follow-up or electronic medical record. Cox regression analysis was used to assess the prognostic influence of bronchiectasis on COPD patients. Results 748 COPD patients were included in this study. 318 patients were identified to have bronchiectasis. During a median follow-up time of 46 months, 624 COPD patients completed follow-up. There were 210 deaths, 112 of whom were comorbid bronchiectasis patients. Comorbid bronchiectasis patients revealed higher mortality than without bronchiectasis patients in 3 years and the whole follow-up, other than in hospital, 1 year and 2 years. The presence of bronchiectasis and its severity were independently associated with increased mortality of COPD patients. The presence of cystic/varicose bronchiectasis revealed higher mortality than cylindrical bronchiectasis and was independently associated with increased mortality of comorbid bronchiectasis patients. Conclusions The presence of bronchiectasis and its severity were independently associated with increased risk of all-cause mortality and mainly affected the long-term mortality of COPD patients. The presence of cystic/varicose bronchiectasis predicted higher death risk of COPD patients.

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