scholarly journals Lung function and peak oxygen uptake in chronic obstructive pulmonary disease phenotypes with and without emphysema

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252386
Author(s):  
Øystein Rasch-Halvorsen ◽  
Erlend Hassel ◽  
Ben M. Brumpton ◽  
Haldor Jenssen ◽  
Martijn A. Spruit ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oxygen Uptake ◽  
Pulmonary Disease ◽  
Peak Oxygen Uptake ◽  
Chronic Obstructive ◽  
P Value ◽  
Linear Regression Models ◽  
Obstructive Pulmonary Disease ◽  
The Difference ◽  
Unit Reduction

Previous studies of associations of forced expiratory lung volume in one second (FEV1) with peak oxygen uptake (VO2peak) in chronic obstructive pulmonary disease (COPD) have not taken sex, age and height related variance of dynamic lung volumes into account. Nor have such demographic spread of spirometric measures been considered in studies comparing VO2peak between COPD phenotypes characterized by degree of emphysema. We aimed to assess the association of FEV1Z-score with VO2peak in COPD (n = 186) and investigate whether this association differs between emphysema (E-COPD) and non-emphysema (NE-COPD) phenotypes. Corresponding assessments using standardized percent predicted FEV1 (ppFEV1) were performed for comparison. Additionally, phenotype related differences in VO2peak were compared using FEV1Z-score and ppFEV1 as alternative expressions of FEV1. E-COPD and NE-COPD were defined by transfer factor of the lung for carbon monoxide below and above lower limits of normal (LLN), respectively. The associations were assessed in linear regression models. One unit reduction in FEV1Z-score was associated with 1.9 (95% CI 1.4, 2.5) ml/kg/min lower VO2peak. In stratified analyses, corresponding estimates were 2.2 (95% CI 1.4, 2.9) and 1.2 (95% CI 0.2, 2.2) ml/kg/min lower VO2peak in E-COPD and NE-COPD, respectively. The association did not differ statistically by COPD phenotype (p-value for interaction = 0.153). Similar estimates were obtained in analyses using standardized ppFEV1. Compared to NE-COPD, VO2peak was 2.2 (95% CI 0.8, 3.6) and 2.1 (95% CI 0.8, 3.5) ml/kg/min lower in E-COPD when adjusted for FEV1Z-score and ppFEV1, respectively. In COPD, FEV1Z-score is positively associated with VO2peak. This association was stronger in E-COPD but did not differ statistically by phenotype. Both the association of FEV1 with VO2peak and the difference in VO2peak comparing COPD phenotypes seems independent of sex, age and height related variance in FEV1. Mechanisms leading to reduction in FEV1 may contribute to lower VO2peak in E-COPD.

scholarly journals Effect of Pharmacy Counseling on Readmissions in Patients with Acute Exacerbations of COPD: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Narachai Prasungriyo ◽  
Nungruthai Sooksai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Direct Costs ◽  
Disease Assessment ◽  
Chronic Obstructive ◽  
P Value ◽  
Intervention Period ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Acute Exacerbations

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.

scholarly journals Inhaler Technique and Adherence to Inhaled Medications among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

2019 ◽  
Vol 16 (2) ◽  
pp. 185 ◽  
Author(s):  
Chau Ngo ◽  
Dung Phan ◽  
Giap Vu ◽  
Phu Dao ◽  
Phuong Phan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Pulmonary Disease ◽  
Associated Factors ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients’ medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: “ignorant” (77.1%), “sporadic” (58.6%), and “deliberate” (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy.

scholarly journals Association of β-blocker use with survival and pulmonary function in patients with chronic obstructive pulmonary and cardiovascular disease: a systematic review and meta-analysis

2020 ◽  
Vol 41 (46) ◽  
pp. 4415-4422 ◽  
Author(s):  
Yan-Li Yang ◽  
Zi-Jian Xiang ◽  
Jing-Hua Yang ◽  
Wen-Jie Wang ◽  
Zhi-Chun Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Difference

Abstract Aims The aim of this study was to clarify the effect of β-blockers (BBs) on respiratory function and survival in patients with chronic obstructive pulmonary disease with cardiovascular disease (CVD), as well as the difference between the effects of cardioselective and noncardioselective BBs. Methods and results We searched for relevant literature in four electronic databases, namely, PubMed, EMBASE, Cochrane Library, and Web of Science, and compared the differences in various survival indicators between patients with chronic obstructive pulmonary disease taking BBs and those not taking BBs. Forty-nine studies were included, with a total sample size of 670 594. Among these, 12 studies were randomized controlled trials (RCTs; seven crossover and five parallel RCTs) and 37 studies were observational (including four post hoc analyses of data from RCTs). The hazard ratios (HRs) of chronic obstructive pulmonary disease exacerbation between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.77 [95% confidence interval (CI) 0.67, 0.89], 0.72 [95% CI 0.56, 0.94], and 0.98 [95% CI 0.71, 1.34, respectively] (HRs &lt;1 indicate favouring BB therapy). The HRs of all-cause mortality between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.70 [95% CI 0.59, 0.83], 0.60 [95% CI 0.48, 0.76], and 0.74 [95% CI 0.60, 0.90], respectively (HRs &lt;1 indicate favouring BB therapy). Patients with Chronic obstructive pulmonary disease treated with cardioselective BBs showed no difference in ventilation effect after the use of an agonist, in comparison with placebo. The difference in mean change in forced expiratory volume in 1 s was 0.06 [95% CI −0.02, 0.14]. Conclusion The use of BBs in patients with chronic obstructive pulmonary disease is not only safe but also reduces their all-cause and in-hospital mortality. Cardioselective BBs may even reduce chronic obstructive pulmonary disease exacerbations. In addition, cardioselective BBs do not affect the action of bronchodilators. Importantly, BBs reduce the heart rate acceleration caused by bronchodilators. BBs should be prescribed freely when indicated in patients with chronic obstructive pulmonary disease and heart disease.

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