scholarly journals ATTITUDE TO HEALTH AND MOTIVATION TO QUIT SMOKING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Author(s):  
E. D. Chetverkina ◽  
A. G. Kozyrev ◽  
G. A. Ivanova ◽  
E. R. Isaeva ◽  
A. I. Kirillova
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.


2017 ◽  
Vol 13 (2) ◽  
pp. 219
Author(s):  
Marsheilla Riska

Abstract: Smoking and Chronic Obstructive Pulmonary Disease (COPD) become a global problem in the world. The increasing number of smokers in the world also led to significantly increased morbidity and mortality due to COPD. Many attempts were made, ranging from government policy that prohibits smoking in public places, to pharmacological therapy, and psychotherapy for smokers. However, often there is a failure to quit smoking. Dependence on nicotine is an important factor that causes someone failed to stop smoking. As for the pharmacological therapy is currently widely used to intervene in nicotine dependence, such as nicotine replacement therapy, bupropion, and varenicline. However, existing therapies have not given satisfactory results in reducing smoking rates and the number of COPD significantly. Therefore, the anti-nicotine vaccine that is currently in development and research, such as NicVAX, NIC002, TA-NIC, and SEL-068, become a new perspective for smokers to stop smoking and prevent long term recurrence. Keywords: nicotine, anti-nicotine, smoking, COPD


2017 ◽  
Vol 15 (3) ◽  
pp. 315-322 ◽  
Author(s):  
Helga Jónsdóttir ◽  
Thorbjörg Sóley Ingadóttir

Recruitment, the process of accessing, screening, selecting and retaining participants for research remains a challenge. In a randomized controlled trial, partnership-based self-management intervention for patients who have chronic obstructive pulmonary disease (COPD) in its initial stages, and their families, a theoretical framework developed for patients with an advanced COPD and their families was modified and implemented in a primary care context. In contrast to recruitment to the original study where 4% decline participation, in this study 25% of the potential patients declined participation. Although participants were encouraged to bring a family member, only 25% of them did so. The main reason for not being accompanied by a family member was that patients did not want anybody accompany them. Those who had quit smoking were more often accompanied by a family member compared to those who smoked. Reviewing the literature, the most compelling explanations for non-participation are shame and self-blame due to smoking, and that potential participants may not have envisioned any benefits from participating since they might not have realized that they had COPD. An alternative recruitment process needs to embrace the situation that potential participants find themselves in and which takes account of the issues at stake.


2019 ◽  
Vol 29 (3) ◽  
pp. 327-333
Author(s):  
G. M. Sakharova ◽  
N. S. Antonov ◽  
Yu. V. Mikhaylova ◽  
M. Yu. Peredel’skaya

Morbidity of chronic obstructive pulmonary disease (COPD) is consistently increasing last decades in Russian Federation. Similarly, the total morbidity is also increasing together with annual healthcare costs. The main risk factor of COPD is tobacco smoking. Therefore, the encouragement of smokers to quit smoking and medical care for nicotine withdrawal should be considered as main factors to control COPD morbidity. Bronchial hyperreactivity could occur early in smokers and COPD could develop in smokers with longer smoking history. Mild to moderate COPD is diagnosed in > 20% of smokers seeking medical aid for nicotine withdrawal. Typically, bronchial hyperreactivity becomes worse after quitting the smoking. This should be considered by a physician and long-acting bronchodilators should be used during nicotine withdrawal. Therefore, an individual plan is necessary for every smoking patient with COPD including quitting the smoking with consideration the severity of nicotine dependence and motivation to quit smoking. The individual plan should also include initiation or optimisation of bronchodilator therapy to prevent worsening of bronchial hyperreactivity. Quitting the smoking is the most effective intervention to slow COPD progression.


2021 ◽  
Vol 31 (4) ◽  
pp. 469-476
Author(s):  
V. I. Kupaev ◽  
D. A. Osipov

From 30 to 43% of smoking patients with chronic obstructive pulmonary disease (COPD) cannot give up nicotine despite the diagnosis and deterioration of health. Most of the publications related to the treatment of COPD do not distinguish smoking patients into a separate group. The aim of this study is a comparative analysis of the effectiveness of long-acting muscarinic antagonists (LAMA), LAMA/long-acting β2 -agonists (LABA) in smoking patients.Methods. The study involved 121 patients with a high degree of nicotine addiction and irreversible bronchial obstruction. All the patients continued to receive bronchodilator therapy. The respondents were divided into two groups: patients who quit smoking and patients who continued to smoke. In turn, each group was divided into two subgroups depending on the treatment – LAMA (Tiotropium 5 μg and Glycopyrronium 50 μg) and LAMA/LABA (tiotropium/olodaterol 5/5 μg and glycopyrronium/idacaterol 50/110 μg). We used the changes of FEV1 and the dynamics of CAT (COPD Assessment Test) as the comparison criteria.Results. The results of the CAT and spirometry showed a tendency to improve in both groups, regardless of the treatment regimen. However, the improvement in symptoms and spirometry parameters were more pronounced in the group of patients who quit smoking: –1 and –11 points, respectively (p < 0.05) and 12 and 23%, respectively (p < 0.05). Comparison of the efficacy of various treatment regimens in the group of smoking patients showed there was no statistically significant difference between LAMA and LAMA/LABA neither in spirometry parameters (11.45 and 13.1%; p < 0.05), nor in the CAT scores (–1.5 and –1.67; p < 0.05). However, combination therapy (LAMA/LABA) was more effective than monotherapy (LAMA) in the group of patients who quit smoking both according to spirometry (25.5 and 13%, respectively; p < 0.05) and CAT (–12.3 and –5.9, respectively; p < 0.05). There was no statistically significant difference between the active substances both in the monotherapy group (tiotropium/glycopyrronium) and in the combination group (tiotropium/olodaterol and glycopyrronium/indacaterol).Conclusion. According to CAT and spirometry, there was no difference between tiotropium and glycopyrronium, nor was there a difference between fixed-dose combinations of tiotropium/olodaterol and glycopyrronium/ indacaterol (both in the group of smokers and in the group of non-smokers). Smoking cessation is key to improving both spirometry and CAT results.


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