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RespiratoryAt@Glance English Archive

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2015 Published by B. Ami Medical Information Ltd.
This service is provided to the IPCRG as a grant from TEVA Pharmaceutical Industries Ltd.
Respiratory At@Glance
IPCRG
76
30/12/2015
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> COPD symptoms predict hospitalization
Abascal-Bolado B et al. Int J Chron Obstruct Pulmon Dis. 2015 Oct 22;10:2295-301.
> FEV1/FEV6 can detect COPD
Wang S et al. Respir Care. 2015 Nov 3. [Epub ahead of print]
> Lung function explains childhood asthma predictors
den Dekker HT et al. J Allergy Clin Immunol. 2015 Nov 5. [Epub ahead of print]
> Asthma drug step down makes sense
Rank MA et al. J Allergy Clin Immunol. 2015 Oct 16. [Epub ahead of print].
> Primary care predictors of COPD hospitalization
Montserrat-Capdevila J et al. Respir Care. 2015 Sep;60(9):1288-94.
> GPs appreciate asthma adherence training
Foster JM et al. J Asthma. 2015 Sep 12:1-24. [Epub ahead of print].
COPD symptoms predict hospitalization
Abascal-Bolado B et al. Int J Chron Obstruct Pulmon Dis. 2015 Oct 22;10:2295-301.
Perceived quality of life according to standardized COPD questionnaires is independently associated with hospitalization risk but daily completion of full questionnaires is impractical in the clinical setting. 496 COPD patients in an outpatient clinic (mean age 70, 54% men) completed the Chronic Respiratory Questionnaire Self-Assessment Survey (CRQ-SAS), underwent lung function tests and were evaluated for clinical outcomes. 3 CRG-SAS items strongly predicted hospitalization: fear/panic of breathlessness, dyspnea with basic daily living activities and symptoms of depression. A brief algorithm based on these items, used in daily clinical care may predict hospitalization.
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FEV1/FEV6 can detect COPD
Wang S et al. Respir Care. 2015 Nov 3. [Epub ahead of print]
The standard diagnostic lung function parameter for diagnosing COPD is FEV1/FVC <0.70. Chinese researchers measured FVC, FEV1 and FEV6 in 767 community centre volunteers (61% female) using portable spirometers in order to assess a cut-off value for FEV1/FEV6 that would correspond to FEV1/FVC <0.70. The cut-off that they found showed the greatest sensitivity and specificity for diagnosing COPD was 0.72, which had sensitivity, specificity, positive and negative predictive values of 95-99% and excellent agreement with the FEV1/FVC cut-off point. The authors concluded this study validated FEV1/FEV6 <0.72 for use in detection of COPD in primary care.
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Lung function explains childhood asthma predictors
den Dekker HT et al. J Allergy Clin Immunol. 2015 Nov 5. [Epub ahead of print]
Prematurity and low birth weight are linked to childhood asthma risk. Data from 24,938 children in 24 birth cohorts was analysed to investigate whether lung functions can explain these associations. FEV1, FEV1/FVC and FEF75 were lower for infants born with younger gestational age. In those born with low weight for gestational age, FEV1 was low but FEV1/FVC was higher. Infants who gained more weight had higher childhood FEV1 and lower FEV1/FVC and FEF75. Asthma risk in childhood was linked to preterm birth, small birth weight and higher infant weight gain and lung function parameters may explain 7-45% of the associations between growth features and asthma.
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Asthma drug step down makes sense
Rank MA et al. J Allergy Clin Immunol. 2015 Oct 16. [Epub ahead of print].
When asthma is well controlled, medications can be stepped down but there is a paucity of data on post-step down outcomes. Analysis of data on persistent asthma patients in the US Medical Expenditure Panel Survey 2000-2010 found 4235 who were eligible to have their treatment stepped down. Asthma control was maintained in 89.4% of those in whom treatment was stepped down and 83.5% of those in whom it was not stepped down despite eligibility for step down. Stepping down treatment was associated with average monthly savings of around $34. The authors concluded that clinical results of treatment step down were similar to those seen without step down while step down saved money.
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Primary care predictors of COPD hospitalization
Montserrat-Capdevila J et al. Respir Care. 2015 Sep;60(9):1288-94.
A Spanish retrospective cohort study investigated chances of primary care COPD patients being admitted to hospital for COPD exacerbations from 2010-2013. They evaluated primary care records for 2501 COPD patients (mean age 68.4, 75% men, COPD severity mild: 50.8%, moderate: 35.3%, severe: 9.4%, very severe: 4.4%). Admissions for COPD exacerbations occurred in 32.5% after 3 years. Clinical features with predictive value for admission were: age, gender, past history of exacerbations, frequency of primary care visits, concurrent illnesses, smoking, COPD severity and vaccination against flu. This model may detect COPD patients in primary care with high hospitalization risk.
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GPs appreciate asthma adherence training
Foster JM et al. J Asthma. 2015 Sep 12:1-24. [Epub ahead of print].
Inadequate asthma drug adherence can affect asthma control. GPs often feel they lack training in asthma medication adherence counselling. In an Australian study 25 GPs received a training session in adherence counselling based on a motivational-interviewing model and counselling support tools. Training was rated as very useful by 96%.After 17 months GPs reported greater confidence in and use of counselling skills and satisfaction level with counselling sessions. GPs found the tools easy to use and they allowed them to cover more ground, but time constraints led to difficulty in counselling implementation for 50%. Patients did not report significant adherence barrier changes.
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Disclaimer:
The service should not be considered as a recommendation for treatment. The abstracts printed here contain only a general description of the main ideas embedded in the original publication. Comments are welcome. Please send any comments to the Project Manager, Linda Kennison at Administration@theipcrg.org
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