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Bartziokas K, Papaporfyriou A, Hillas G, Papaioannou AI, Loukides S. Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations: strengths and concerns for future needs. Postgrad Med 2022; 135:327-333. [PMID: 36226501 DOI: 10.1080/00325481.2022.2135893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is already the third leading cause of death worldwide and simultaneously a major cause of morbidity and mortality. Global initiative for Chronic Obstructive Lung Disease (also known as GOLD) committee, has been created in 1997 to increase the awareness regarding the burden of COPD. GOLD recommendations have been contributing to diagnosis, management and therapy of COPD since 2001. Through these years, by reviewing published articles, GOLD aimed to provide state-of-the-art information not only for pulmonologists, but also for non-respiratory physicians, and to encourage research on COPD. From 2011, GOLD annual reports have changed the way of COPD evaluation from based entirely on spirometric parameters to more clinical indices, such as the assessment of symptoms and dyspnea alongside with exacerbations. Moreover, according to recent developments in pathophysiology of COPD, there is a trend in identifying new pre-clinical stages, contributing to prevention and early COPD treatment. In the field of therapeutic algorithms, changes turn to a more personalized approach. However, it is not clear in what extent this personalized disease management would be feasible and the real challenge for current recommendations is to include more patient characteristics such as co-morbidities and multidimensional scores in disease evaluation.
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Affiliation(s)
| | | | - Georgios Hillas
- 5th Respiratory Medicine Department Sotiria Chest Hospital, Athens, Greece
| | | | - Stelios Loukides
- 2nd Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
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Alves L, Pullen R, Hurst JR, Miravitlles M, Carter V, Chen R, Couper A, Dransfield M, Evans A, Hardjojo A, Jones D, Jones R, Kerr M, Kostikas K, Marshall J, Martinez F, van Melle M, Murray R, Muro S, Nordon C, Pollack M, Price C, Sharma A, Singh D, Winders T, Price DB. CONQUEST: A Quality Improvement Program for Defining and Optimizing Standards of Care for Modifiable High-Risk COPD Patients. Patient Relat Outcome Meas 2022. [DOI: 10.2147/prom.s296506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Peng Y, Duan J, Li X, Zeng Y, Zhou Z, Deng M, Ouyang R, Chen Y, Cai S, Chen P. Adherence to Inhaled Therapy in Patients with COPD Associated to Pneumoconiosis. Int J Chron Obstruct Pulmon Dis 2021; 16:2697-2706. [PMID: 34611398 PMCID: PMC8485917 DOI: 10.2147/copd.s327686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pneumoconiosis has high prevalence of chronic obstructive pulmonary disease (COPD), respiratory morbidity, and mortality. Objective The aim of the present study was to examine patient characteristics and adherence to inhaled therapy among pneumoconiosis with COPD in a real-world clinical setting. Methods A cohort of pneumoconiosis patients with COPD prescript with at least one type of long-acting inhaled drug was followed for adherence for 2 years. Demographic and COPD-related characteristics were collected in baseline. Results In baseline, after adjusting for age, dust exposure duration positively correlated with number of acute exacerbation (AE) frequency in the last year. There were close associations among COPD Assessment Tool (CAT) score, modified Medical Research Council Dyspnea Scale (mMRC) grade, number of AE, and pre-FEV1 value. Of 296 participants originally recruited, 213 participants finished the 2-year follow-up for adherence. 122 (57.28%) were non-adherent to inhaled therapy. The most common reason for non-adherence was “relief of symptoms after short-term controller medication use” (53.28%). Patients who were non-adherent reported higher body mass index (BMI), less AE events in the last year, higher pre-FEV1 value, higher post-FEV1 value and low CAT, mMRC scores compared to adherent in baseline. High pre-FEV1 value (OR = 1.04, CI = 1.018–1.064) and low mMRC scores (OR = 0.406, CI = 0.214–0.771) were risk factors found associated with non-adherence. Conclusion A majority of pneumoconiosis patients complicated with COPD have suboptimal inhaled therapy adherence. Evidence-based, adherence-enhancing interventions should be targeted on less severe subjects.
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Affiliation(s)
- Yating Peng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Jiaxi Duan
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Xin Li
- Division of Occupational Lung Disease, Hunan Prevention and Treatment Institute for Occupational Diseases, Changsha, Hunan, People's Republic of China
| | - Yuqin Zeng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Zijing Zhou
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Minghua Deng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China.,Department of Respiratory, PLA Rocket Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Ruoyun Ouyang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Yan Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Shan Cai
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People's Republic of China.,Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People's Republic of China
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