scholarly journals Practice and Effect Evaluation of Drug Reorganization in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 5 (5) ◽  
pp. 130-135
Author(s):  
Peng Yan ◽  
Laiji Zhou ◽  
Chunwang Hua ◽  
Ping Gan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Multiple Dimensions ◽  
Copd Patients ◽  
Significant Difference ◽  
Data Statistics ◽  
Group 2 ◽  
The Cost

Objective: To explore the feasibility of drug reorganization in clinical practice through the drug reorganization service of clinical pharmacists for patients with chronic obstructive pulmonary disease (COPD) in respiratory and critical care department, and to evaluate the effect of the service in multiple dimensions. Methods: a total of 100 patients with COPD admitted from January to July 2021 were randomly divided into two groups with 50 patients in each group. One group was treated with drug reforming intervention and the other group was not treated with intervention. Statistics and data analysis were carried out from three aspects: patient compliance, satisfaction and medication deviation. Results: (1) compliance: 48h after admission, there was no significant difference between the two groups (P>0.05); According to the data statistics on the day of discharge and after one month, the compliance of the two groups was statistically significant (P<0.05), which was higher in the reorganization group. (2) Satisfaction: There was no significant difference between the two groups after admission. However, after drug reforming intervention by pharmaceutical staff, the results of reforming group were better and statistically significant (P<0.05). (3) Medication deviation: There were 50 deviations in the reorganization group, of which drug omission accounted for 52%, which was the main factor. After communicating with clinicians, the clinicians’ acceptance rate of the reorganization scheme reached 94.12%. Conclusion: The implementation of drug reorganization service can effectively prevent the medication deviation of COPD patients, save the cost of patients, improve the satisfaction and compliance, and ensure the medication safety of patients.

scholarly journals Predictive Factors for the Effect of Treatment by Noninvasive Ventilation in Patients with Respiratory Failure as a Result of Acute Exacerbation of the Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (4) ◽  
pp. 655-660 ◽  
Author(s):  
Sava Pejkovska ◽  
Biserka Jovkovska Kaeva ◽  
Zlatica Goseva ◽  
Zoran Arsovski ◽  
Jelena Jovanovska Janeva ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Failure Group ◽  
Copd Patients ◽  
Arterial Ph ◽  
Increased Risk ◽  
Group 2

BACKGROUND: Noninvasive mechanical ventilation (NIV) applies ventilator support through the patient’s upper airway using a mask.AIM: The aim of the study is to define factors that will point out an increased risk of NIV failure in patients with exacerbation of Chronic Obstructive Pulmonary Disease (COPD).PATIENTS AND METHODS: Patients over the age of 40, treated with NIV, were prospectively recruited. After data processing, the patients were divided into two groups: 1) successful NIV treatment group; 2) failed NIV treatment group.RESULTS: On admission arterial pH and Glasgow coma scale (GCS) levels were lower (pH: p < 0.05, GCS: p < 0.05), and Acute Physiology and Chronic Health Evaluation II (APACHE) score and PaCO2 were higher (p < 0.05) in the NIV failure group. Arterial pH was lower (p < 0.05) and PaCO2 and respiratory rate were higher (p < 0.05) after 1h, and arterial pH was lower (p < 0.05) and PaCO2 (p < 0.05), respiratory and heart rate were higher (p < 0.05) after 4h in the NIV failure group.CONCLUSION: Measurement and monitoring of certain parameters may be of value in terms of predicting the effectiveness of NIV treatment.

Association Between Interleukin-6 Blood Level and Chronic Obstructive Pulmonary Disease Severity

2020 ◽  
Vol 17 (7) ◽  
pp. 3097-3103
Author(s):  
Theopilus Obed Lay ◽  
Muhammad Amin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Proinflammatory Cytokines ◽  
Interleukin 6 ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Severity Level ◽  
Copd Patients ◽  
Significant Difference

Chronic obstructive pulmonary disease (COPD) is known as a chronic inflammatory disease that not only occurs in the lung, but also affects the systemic. A continuous chronic inflammation in COPD patients will have an increased proinflammatory cytokines, both in COPD patients’ respiratory tract and blood. Interleukin-6 (IL-6) is one of proinflammatory cytokines that increases with COPD progression. IL-6 level examination in COPD patient’s blood as a systemic inflammation indicator is convenient and quick. The research aimed to measure IL-6 level in COPD patient’s serum, to determine COPD severity level, and to analyze correlation between IL-6 and severity level. The research is an observational analytic study using cross sectional design. The samples were 38 non-exacerbated COPD outpatients who visited Lung Unit at Dr. Soetomo Teaching Hospital, Surabaya, Indonesia and met inclusion and exclusion criteria. The study found no significant correlation between IL-6, COPD severity level, COPD obstruction, first forced expiratory volume (FEV1), and FEV1/forced vital capacity (FVC), with p > 0.05. There was a significant correlation between IL-6 level, body mass index (BMI), and COPD assessment test (CAT) score, with p < 0.05, while there was no significant difference of IL-6 level between high-risk and low-risk patients, with p = 0.066 (p > 0.05). Moreover, there was a significant difference of IL-6 level between group A and D, with p = 0.040 (p < 0.05). There were no significant correlation and difference between COPD severities, COPD obstruction, FEV1, FVC, FEV1/FEC ratio, smoking duration with stable IL-6.

The cost-effectiveness of antidepressants for smoking cessation in chronic obstructive pulmonary disease (COPD) patients

Addiction ◽  
2009 ◽  
Vol 104 (12) ◽  
pp. 2110-2117 ◽  
Author(s):  
Constant P. Van Schayck ◽  
Janneke Kaper ◽  
Edwin J. Wagena ◽  
Emiel F. M. Wouters ◽  
Johannes L. Severens
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Cost

scholarly journals Electrocardiographic changes in Chronic Obstructive Pulmonary Disease patients with elevated Pulmonary Artery Systolic Pressure

2013 ◽  
Vol 8 (1) ◽  
pp. 12-15 ◽  
Author(s):  
S Humagain ◽  
S Keshari ◽  
R Gurung ◽  
P Pant ◽  
B Pokharel ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Artery ◽  
Pulmonary Disease ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Retrospective Case ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference

Background Chronic Obstructive Pulmonary Disease (COPD) is a common global problem and most common medical problem in Nepal having significant morbidity and mortality. One of the pathogenesis of COPD in long run is the elevation of Pulmonary Artery Systolic Pressure (PASP) leading to right heart failure. A simple investigation - an Electrocardiograph (ECG) is assessed to co-relate with elevated PASP measured by Echocardiography in COPD patients of Dhulikhel Hospital. Methods and Materials A retrospective case control study of 342 COPD patients was done with assessment of ECG to co-relate with elevated PASP and with normal PASP. Data were analyzed using SPSS 17. Result There was significant difference in mean age, P amplitude in Lead II, III and aVF, QRS axis and R wave in V1 and S in V6 between two groups. Conclusion ECG changes are fairly sensitive and specific for elevation of PASP. DOI: http://dx.doi.org/10.3126/njh.v8i1.8330 Nepalese Heart Journal Vol.8(1) 2011 pp.12-15

scholarly journals Chronic obstructive pulmonary disease risk and smoking cessation changes induced by CHRNA5-A3 and CHRNB3-A6 variation in a Chinese male population

2019 ◽  
Vol 22 (2) ◽  
pp. 51-58
Author(s):  
L Zhao ◽  
L-Y Zou ◽  
B-F Cheng ◽  
X-J Yu ◽  
J-H Zou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Smoking Cessation ◽  
Pulmonary Disease ◽  
Disease Risk ◽  
Chronic Obstructive ◽  
Male Population ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference ◽  
Chinese Male

AbstractMost studies in the field of CHRNA5-A3 and CHRNB3-A6 have only focused on lung cancer risk; however, the associations with chronic obstructive pulmonary disease (COPD) risk and smoking cessation is less understood, particularly in the Chinese male population. In this study, samples from 823 male patients with COPD (non smokers: 416; still smoking: 407) and 435 smoking male healthy control subjects were performed with DNA extraction and single nucleotide polymorphism (SNP) genotyping. We studied three SNPS in two genes, namely rs667282 and rs3743073 in CHRNA5-A3 and rs4950 in CHRNB3-A6, and their distributions in the three groups are not statistically different (p >0.05). We grouped COPD patients according to whether they had successfully quit smoking, the CT genotype of rs667282 demonstrated association with an increased rate of successful smoking cessation compared with the TT genotype [adjusted odds ratio (OR) = 0.54, 95% confidence interval (95% CI) = 0.37-0.7, p <0.001); rs4950 AG genotypes were distinctly associated with increased rates of successful smoking cessation (adjusted OR = 0.55, 95% CI = 0.40-0.76, p <0.001). The effect is significant under the assumption of an over dominant mode of inheritance (adjusted OR = 0.58, 95% CI = 0.43 to 0.79, p <0.001). No significant difference in rs3743073 was found (p >0.05). Our findings confirmed the hypothesis that CHRNA5-A3 and CHRNB3-A6 variation are not associated with the risk of COPD. We found CHRNA5-A3 and CHRNB3-A6 were significantly associated with successful smoking cessation in smoking COPD patients.

scholarly journals The influence of pulmonary rehabilitation on the exacerbations of chronic obstructive pulmonary disease in Serbia

2020 ◽  
Vol 148 (5-6) ◽  
pp. 344-349
Author(s):  
Miroslav Ilic ◽  
Ivan Kopitovic ◽  
Danijela Kuhajda ◽  
Biljana Zvezdin ◽  
Nensi Lalic ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Multivariate Logistic Regression Analysis ◽  
Chronic Obstructive ◽  
Observation Study ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference ◽  
Seasonal Flu

Introduction/Objective. The chronic obstructive pulmonary disease (COPD) exacerbations have a major impact on outcomes of COPD patients. Pulmonary rehabilitation (PR) interrupts the vicious circle caused by exacerbations. It has not been widely implemented as standard of COPD treatment yet. The aim of study was to examine the effectiveness of PR in prevention of exacerbations. Method. The prospective observation study included stable COPD patients between January 2015 and December 2018. The effects of PR on exacerbation rates were evaluated using univariate and multivariate logistic regression analysis, taking into account age, comorbidity, vaccination status (against seasonal flu), body mass index (BMI). Results. Study included 1,674 patients (956 males, age 65.93 ?} 8.45, current or ex-smokers 94.9%; 21 ? BMI 1,406 patients, 84%, FEV1 < 80% 1,448 patients, 86.5%). The PR rate was 48.1%. There was significant difference in PR status with respect to age (p = 0.020), comorbidities (p = 0.015), FEV1 (p < 0.001), respiratory symptoms using COPD assessment test (CAT) score (p < 0.001), vaccination against seasonal flu (p < 0.001). Exacerbations occurred more frequently in non-PR patients (415 (51.6%) vs. 641 (73.7%), p < 0.001). In multivariate analysis, PR (RR 0.421; 95% CI (0.307?0.577); p < 0.001) and BMI ? 21kg/m2 (RR 0.605; 95% CI (0.380?0.965); p = 0.035) were independent protective factors and CAT score >10 (RR 2.375; 95% CI (1.720?3.280); p < 0.001) and FEV1 < 80% (RR 2.021; 95% CI (1.303?3.134); p = 0.002) were independent risk factors from exacerbations. Conclusion. Patients who successfully completed PR treatment had significantly less frequent exacerbations compared to patients that not pass through PR program.

scholarly journals The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kimberly Stephens Rudd ◽  
Tiffany Jackman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
The United States ◽  
Chronic Obstructive ◽  
Healthcare Outcomes ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Additional Costs ◽  
The Cost ◽  
The Relationship

A literature review conducted, on the cost of Chronic Obstructive Pulmonary Disease (COPD) between patients who are compliant versus non-compliant, reflects on the data for the United States with an emphasis on the areas within the Florida Panhandle. An overview of costs associated with noncompliant COPD patients and strategies for encouraging patients to adhere to treatment and improve healthcare outcomes is provided. A review of recent peer-reviewed articles was performed to determine the additional costs associated with non-compliance. The direct cost of COPD was estimated at $6,246 per patient annually. Nationally projected expenditures for COPD were $49.9 billion in 2010, while costs in Florida were $2.5 billion. Florida’s costs for COPD management ranks much higher than the national average. Potential causes for the differentiation are associated with newer medications and devices that contribute to a higher out-of-pocket expense for patients, patient denial about the seriousness of their illness, and/or inability to understand compliance with treatment. The relationship between the primary care provider and COPD patient is critical for adherence to therapy.

scholarly journals The effect of comorbidity severity on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients

2018 ◽  
Vol 16 ◽  
pp. 147997231880947
Author(s):  
Ilknur Naz ◽  
Hulya Sahin ◽  
Yelda Varol ◽  
Berna Kömürcüoğlu
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Pulmonary Function Tests ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Group 2

Chronic obstructive pulmonary disease (COPD) is not only associated with respiratory system involvement but also with systemic consequences leading to chronic comorbidities. In this study, we aimed to investigate the effect of comorbidity severity on pulmonary rehabilitation (PR) outcomes in COPD patients. We conducted a retrospective cohort study to compare the effectiveness of PR in COPD patients who completed an 8-week PR program. There were at least one comorbid in 120 of 211 patients and we divided them into the groups according to Charlson Comorbidity Index (CCI) scores (1 points, group 1 ( n = 54); 2 points, group 2 ( n = 41); 3 points, group 3 ( n = 25)). We compared 6-minute walk distance (MWD), dyspnea perception, pulmonary function tests, blood gases analysis, quality of life, anxiety, and depression scores which were recorded before and after PR between the groups. Before PR 6-MWD distance was significantly lower in group 2 ( p = 0.033). Improvements in 6-MWD, blood gas values, dyspnea perception, quality of life, and anxiety were determined in all groups after PR ( p < 0.05). When the gains after PR were compared, there were no significant differences between groups ( p > 0.05). COPD patients benefit from PR independent from their comorbidity severity. Comorbidity severity has no effect on PR gains. Therefore, patients with comorbidities should not be excluded from PR programs and encouraged to participate. Clinical Trial Number: NCT03319108.

Motion of the Diaphragm in Patients with Chronic Obstructive Pulmonary Disease while Spontaneously Breathing versus  during Positive Pressure Breathing after Anesthesia and Meeting Abstracts

2002 ◽  
Vol 97 (2) ◽  
pp. 298-305 ◽  
Author(s):  
Bruce S. Kleinman ◽  
Kerry Frey ◽  
Mark VanDrunen ◽  
Taqdees Sheikh ◽  
Donald DiPinto ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Normal Subjects ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Control Subjects ◽  
Copd Patients ◽  
Significant Difference

Background Diaphragmatic excursion during spontaneous ventilation (SV) in normal supine volunteers is greatest in the dependent regions (bottom). During positive pressure ventilation (PPV) after anesthesia and neuromuscular blockade and depending on tidal volume, the nondependent region (top) undergoes the greatest excursion, or the diaphragm moves uniformly. The purpose of this study was to compare diaphragmatic excursion (during SV and PPV) in patients with chronic obstructive pulmonary disease (COPD) with patients having normal pulmonary function. Methods Twelve COPD patients and 12 normal control subjects were compared. Cross-table diaphragmatic fluoroscopy was performed while patients breathed spontaneously. After anesthetic induction and pharmacologic paralysis and during PPV, diaphragmatic fluoroscopy was repeated. For analytic purposes, the diaphragm was divided into three segments: top, middle, and bottom. Percentage of excursion of each segment during SV and PPV in normal subjects was compared with the percentage of excursion of each segment in patients with COPD. Results There was no significant difference in the pattern of regional diaphragmatic excursion (as a percentage of total excursion)-top, middle, bottom-when comparing COPD patients with control subjects during SV and PPV. In the control subjects, regional diaphragmatic excursion was 16 +/- (5), 33 +/- (5), 51 +/- (4) during SV and 49 +/- (13), 32 +/- (6), 19 +/- (9) during PPV. In COPD patients, regional diaphragmatic excursion was 18 +/- (7), 34 +/- (5), 49 +/- (7) during SV and 47 +/- (10), 32 +/- (6), 21 +/- (9) during PPV. Conclusion Regional diaphragmatic excursion in patients with COPD during SV and PPV is similar to that in persons with normal pulmonary function.

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