Gender does not impact the short- or long-term outcomes of home-based pulmonary rehabilitation in patients with COPD

[Effects of gender on pulmonary rehabilitation outcomes in patients with COPD]

INTRODUCTION

COPD has become more prevalent among women, revealing a specific feminine phenotype. Women experience greater dyspnea and a more impaired quality of life. The main objective of this study was to assess the effect of gender on dyspnea during a pulmonary rehabilitation program (PRP).

METHODS

Retrospective study including COPD patients having participated in PRPs. The following data were analyzed according to gender before and after a PRP: dyspnea, quality of life, anxiety and depression, exercise capacity, muscle function (quadriceps and inspiratory muscles).

RESULTS

More than 500 patients (252 men and 252 women) were included. We did not find a significant effect of gender on the evolution of dyspnea, anxiety or depressive disorders, exercise capacity, inspiratory muscle strength, or overall quality of life score. That said, we found a possible effect on the sub-scores of the quality of life questionnaire, and regarding quadriceps strength. All criteria improved during the program in both groups.

CONCLUSIONS

During a PRP, gender does not impact the evolution of dyspnea. While women may nonetheless benefit to a greater extent in terms of quality of life sub-scores (impact, activities, symptoms) and quadriceps strength, these results still require confirmation.

Perceptions of the effectiveness of non-pharmacological management of respiratory disorders among CRD patients

Chronic respiratory diseases (CRDs) are among the leading cause of mortality worldwide. While pharmacological approaches are commonly used to manage symptoms, non-pharmacological management of CRDs is considered crucial in preventing disease progression and improving patient self-efficacy. To describe the perceived effectiveness of non-pharmacological management of CRDs among CRD patients and determine whether the CRD patients perceptions of the effectiveness of non-pharmacological management are associated with their demographic characteristics. An analytic cross-sectional study design was utilized. The non-pharmacological management practices of CRD patients and their perception of the effectiveness of these therapeutic measures were assessed using a researcher-developed questionnaire. Data collection took place in primary healthcare centers in Al Ahsa, Saudi Arabia from October 2021 to March 2022. The proportion of CRD patients who perceived that non-pharmacological interventions were effective was computed. Binary logistic regression was performed to determine the association between the demographic characteristics of the respondents and their perception of the effectiveness of non-pharmacological management. Among the 390 respondents, 42% perceived that non-pharmacological measures were effective. Half of the respondents believed that smoking cessation, influenza vaccination, improving physical activity, and nutrition support helped alleviate CRD symptoms, while less than half of the respondents considered pulmonary rehabilitation, educational programs, and oxygen therapy effective measures to control symptoms. Women were found to be 3.24 times more likely to perceive non-pharmacological interventions as effective (P < .0000) compared to men. Those with university-level education were 66.6% less likely to consider non-pharmacological interventions to be effective (P < .0000) than those who completed preuniversity-level education. Age and marital status did not significantly influence perceptions of effectiveness. Differences in the perceptions of the effectiveness of various non-pharmacological measures to alleviate CRD symptoms existed among the CRD patients of Al Ahsa. The perception of effectiveness was significantly associated with the patient's gender and educational attainment.

Gender differences in pulmonary function, physical activity, and quality of life of patients with COPD based on data from the Korea National Health and Nutrition Examination Survey 2015 to 2019 from the Perspective of Pulmonary Rehabilitation

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide, with the fourth highest mortality rate. This study aims to analyze pulmonary function, physical activity, and quality of life (QoL) between genders from the perspective of pulmonary rehabilitation in Korean patients with COPD. This study investigated raw data from the Korea National Health and Nutrition Examination Survey from 2015 to 2019 and included 151 COPD patients (men: 66.55 ± 10.07 years, women: 65.21 ± 11.73) out of 39,759 participants. Pulmonary function, such as forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), and frequency of physical activities (e.g., physical activity for work and leisure, strengthening exercise, and sitting time a day) and QoL by using EQ-5D-3L, were compared between genders in patients with COPD. Smoking status differed in health-related characteristics between genders (P < .001). In pulmonary function, the FVC (men: 3.48 ± 0.98ℓ, women: 2.53 ± 0.56ℓ, P < .05), FEV1 (men: 2.13 ± 0.93 ℓ, women: 1.88 ± 0.53 ℓ, P < .001), FEV6 (men: 3.16 ± 1.00ℓ, women: 2.46 ± 1.56ℓ, P < .001) and peak expiratory flow (men: 5.61 ± 2.44ℓ/s, women: 4.68 ± 1.53ℓ/s, P < .05) was higher in men, however, predicted FEV1 (men: 66.03% ± 23.13%, women: 79.95% ± 18.45%, P < .05) and predicted FEV1/FVC ratio (men: 59.67% ± 15.02%, women: 74.10% ± 10.49%, P < .001) in women. The frequency of strengthening exercise was higher in men (P < .05). QoL of patients with COPD was not significantly different between genders. To provide correct interventions and pulmonary rehabilitation to patients with COPD, gender differences, including physiological and psychological differences, must be considered.

Differences Between Men and Women with Chronic Obstructive Pulmonary Disease

There are many differences between men and women in risk factor vulnerability and impact, symptom development, presentation, clinical manifestations, and outcomes of chronic obstructive pulmonary disease (COPD). These differences have been inadequately explored, which is of particular concern in view of the delay in diagnosis and treatment that occurs for both men and women, and the need to use all therapies in a targeted and tailored way for best clinical gain and least harm. Women are generally underrepresented in randomized trials, as are non-tobacco-related phenotypes of COPD. We must garner the information available to better describe optimal treatment approaches.

Sex differences in COPD management

Introduction: A growing body of evidence indicates that prevalence of chronic obstructive pulmonary disease (COPD) has been increasing more rapidly among women compared to men, but the available data on the differences between the sexes in the responses to the various COPD therapies are still scarce.Areas covered: The aim of this narrative review is to provide an overview of current knowledge on sex differences in COPD management.Expert opinion: There is no solid evidence of sex differences in response to usual COPD treatments but there are sex-related differences in management of patients with a clinical diagnosis of COPD. It is difficult to explain the reason for these differences, but most likely they are due to local prescribing habits, rather than solid scientific reasons. However, there are also signals of different sex-related responses, the qualification and quantification of which is difficult with the information currently available. These signals should lead to the inclusion of more women in clinical trials, but also to the design of prospective clinical studies to assess the possible differences linked to sex in COPD treatment responses, whose identification is an important step toward the definition of personalized COPD therapy.

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death across the globe. Its repeated exacerbation will seriously worsen the quality of life, aggravate the patients’ symptoms, and bring a heavy burden on the patients and the society. Understanding the current status of drug therapy and the role of pharmaceutical care is essential for the management of COPD. In addition to the drugs already on the market, recent clinical trials also show that emerging novel drugs for treating COPD are being developed to prevent the symptoms, reduce the frequency of acute exacerbation, and improve the quality of life. Recent progress in new drug research should lead to novel treatment options for COPD patients in future clinical practice. The pharmaceutical care has shown significantly favourable impacts on addressing drug-related problems, supporting its vital role in the management of COPD, especially when there are a wide range of therapeutic agents. This review not only provides an overview of current treatment strategies but also further underlines the importance of new drug development and pharmaceutical care for patients with COPD.