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Chiner Vives E, Fernández Fabrellas E, Agüero Balbín R, Martínez García MÁ. Aerosolterapia. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Brophy C, Kastelik JA, Gardiner E, Greenstone MA. Quality of life measurements and bronchodilator responsiveness in prescribing nebulizer therapy in COPD. Chron Respir Dis 2008; 5:13-8. [PMID: 18303097 DOI: 10.1177/1479972307087652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Nebulized bronchodilators are widely regarded as the optimal treatment for maintenance therapy in patients with severe chronic obstructive pulmonary disease (COPD). The aim of the study was to assess whether detailed physiological, functional and quality of life-related measurements can assist in determining the requirement for nebulized bronchodilator therapy in patients with moderate to severe COPD. This was an unblinded, randomized, crossover study that compared intermediate (120mcg ipratropium bromide and 600mcg of salbutamol using metered dose inhaler (MDI) and spacer) and high dose (nebulized 500 mcg ipratropium bromide and 2.5 mg salbutamol) bronchodilator therapy, on physiological, functional and quality of life-related measurements in patients with COPD. A total of 25 patients (12 female), mean (SD) age 68 (7) years, FEV1 45 (10) % predicted completed the study. There was no statistically significant difference between the treatments in the pre- and post-bronchodilator lung function values, six-minute walk distance, breathlessness score or quality of life questionnaires. Fifteen patients preferred bronchodilator therapy with nebulizer and 10 with MDI and spacer. In 20 patients at least one positive response in quality of life score, lung function or six-minute walk, was observed on the preferred treatment. Only a proportion of patients with moderate or severe COPD prefer nebulized bronchodilator therapy. This study found that none of the parameters singly or in combination were consistently predictive of patients' preference for nebulized bronchodilator therapy. Therefore, we suggest that clinicians institute a trial of stepping up to an intermediate dose of bronchodilators prior to introducing nebulized therapy. Chronic Respiratory Disease 2008; 5: 13—18
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Affiliation(s)
- C. Brophy
- Medical Chest Unit, Castle Hill Hospital, Castle Road, Cottingham Hull, East Yorkshire HU16 5JQ
| | - JA Kastelik
- Medical Chest Unit, Castle Hill Hospital, Castle Road, Cottingham Hull, East Yorkshire HU16 5JQ
| | - E. Gardiner
- Department of Clinical Psychology, Hertford Building, West Campus University of Hull HU6 7RX, UK
| | - MA Greenstone
- Medical Chest Unit, Castle Hill Hospital, Castle Road, Cottingham Hull, East Yorkshire HU16 5JQ
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Smith EC, Kendrick AH, Brewin A. Staff education. Thorax 1997; 52 Suppl 2:S102-3. [PMID: 9155862 PMCID: PMC1765863 DOI: 10.1136/thx.52.2008.s102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- E C Smith
- Department of Medicine, Bristol Royal Infirmary, UK
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