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Choate R, Holm KE, Sandhaus RA, Mannino DM, Strange C. Long-Term SGRQ Stability in a Cohort of Individuals with Alpha-1 Antitrypsin Deficiency-Associated Lung Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:889-900. [PMID: 38617018 PMCID: PMC11016265 DOI: 10.2147/copd.s443183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
Background Health-related quality of life (HRQoL) assessments such as St. George's Respiratory Questionnaire (SGRQ) are often used as outcome measures to evaluate patient-perceived changes in health status among individuals with lung disease. Several factors have been linked to deterioration in SGRQ, including symptoms (dyspnea, wheezing) and exercise intolerance. Whether these findings apply to individuals with alpha-1 antitrypsin deficiency (AATD) remains incompletely studied. This longitudinal study examines the trajectory of SGRQ scores in a cohort of United States individuals with AATD-associated lung disease and defines factors associated with longitudinal change. Methods Individuals with AATD-associated lung disease enrolled in AlphaNet, a disease management program, who had ≥3 SGRQ measurements collected between 2009 and 2019, and baseline data for clinically important variables were included in these analyses. Data collected after lung transplants were excluded. Mixed-effects model analyses were used to evaluate the changes in SGRQ total and subscale scores over time and by modified Medical Research Council (mMRC) Scale, use of oxygen, age, sex, productive cough, and exacerbation frequency at baseline. Sensitivity analyses were conducted to examine the potential effect of survivor bias. Results Participants (n=2456, mean age 57.1±9.9 years, 47% female) had a mean SGRQ total score of 44.7±18.9 at baseline, 48% used oxygen regularly, and 55% had ≥2 exacerbations per year. The median length of follow-up was 6 (IQR 3-9) years. The SGRQ total score and subscales remained stable throughout the observation period. Age, mMRC categories, presence or absence of productive cough, frequency of exacerbations, and use of oxygen at baseline were significantly associated with the rate of change of SGRQ total (p<0.0001). Conclusion We observed long-term stability in HRQoL and an association between the rate of change in SGRQ and baseline mMRC, exacerbation frequency, productive cough, and use of oxygen in this cohort of individuals with AATD-associated lung disease.
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Affiliation(s)
- Radmila Choate
- University of Kentucky College of Public Health, Lexington, Kentucky, USA
| | - Kristen E Holm
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
- Alphanet, Inc., Coral Gables, Florida, USA
| | - Robert A Sandhaus
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
- Alphanet, Inc., Coral Gables, Florida, USA
| | - David M Mannino
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Charlie Strange
- Alphanet, Inc., Coral Gables, Florida, USA
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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2
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Choate R, Holm KE, Sandhaus RA, Mannino DM, Strange C. Characteristics associated with SF-36 in alpha-1 antitrypsin deficiency-associated COPD: a cross-sectional analysis. BMC Pulm Med 2024; 24:138. [PMID: 38500152 PMCID: PMC10949668 DOI: 10.1186/s12890-024-02953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Generic measures of health-related quality of life (HRQoL), such as the 36-Item Short Form Survey (SF-36), are widely used in assessing chronic conditions. These tools have an advantage over disease-specific instruments, as they allow comparisons across different health conditions and with the general population. In alpha-1 antitrypsin deficiency (AATD)-associated chronic obstructive pulmonary disease (COPD), HRQoL research remains scarce. This cross-sectional study evaluates the factors associated with HRQoL in a cohort of patients with AATD-associated COPD. METHODS Our study included participants of AlphaNet (2008-2019), a health management organization for people with AATD in the US who are prescribed augmentation therapy. Norm-based SF-36 scores for the mental and physical component summary scores (MCS and PCS, mean of 50 ± 10 in the general US population) and 8 individual scales were evaluated. Individuals with lung disease and data available on ≥1 measurement on any SF-36 scale and clinically relevant characteristics such as modified Medical Research Council (mMRC) scale, exacerbation frequency, productive cough, and use of oxygen were included in these analyses. Generalized linear regression models were fit to examine the association of baseline characteristics with MCS and PCS scores. Age, sex, regular use of oxygen, exacerbation frequency, mMRC, and productive cough were included in these models. RESULTS Participants (n=4398, mean age 57.6 [SD=10.6] years, 45.4% female) had a mean MCS score of 51.2 ± 10.8 and PCS of 36.3 ± 9.8. The average mMRC score was 2.4 ± 1.3, and 56.4% had 2 or more exacerbations per year. Overall, the physical component of SF-36 was more severely impacted compared to the mental component. In multivariable regression analyses, PCS scores were significantly associated with exacerbation frequency, mMRC, regular use of oxygen, and productive cough; MCS was associated with age, sex, exacerbation frequency, mMRC, and productive cough. CONCLUSIONS These findings demonstrate that patient-perceived physical health is significantly impaired in this cohort of people with AATD-associated COPD compared to mental health. Longitudinal studies are needed to evaluate the change in physical and mental health status over time in this population.
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Affiliation(s)
- Radmila Choate
- University of Kentucky College of Public Health, Lexington, Kentucky, United States.
| | - Kristen E Holm
- Department of Medicine, National Jewish Health, Denver, Colorado, United States
- AlphaNet, Inc, Coral Gables, Florida, United States
| | - Robert A Sandhaus
- Department of Medicine, National Jewish Health, Denver, Colorado, United States
- AlphaNet, Inc, Coral Gables, Florida, United States
| | - David M Mannino
- University of Kentucky College of Medicine, Lexington, Kentucky, United States
| | - Charlie Strange
- AlphaNet, Inc, Coral Gables, Florida, United States
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
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Donohue JF, Ferguson GT, Ohar JA, Lombardi DA, Schneider RF, Johnson K. Improvements in health status with revefenacin, a once-daily, nebulized, long-acting muscarinic antagonist for chronic obstructive pulmonary disease. Respir Med 2023; 208:107123. [PMID: 36681255 DOI: 10.1016/j.rmed.2023.107123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/27/2022] [Accepted: 01/17/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Replicate, 12-week, phase 3 trials (0126 and 0127) of once-daily nebulized revefenacin 175 μg vs placebo demonstrated significant bronchodilation and improvements in health status in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). This post hoc analysis evaluated improvement in patient-reported outcomes (PROs), including the St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and Clinical COPD Questionnaire (CCQ) in both women and men. METHODS Participants were pooled from the two 12-week studies (411 [51%] women and 401 [49%] men). Changes in PROs were assessed overall and separately in men and women. RESULTS Revefenacin improved SGRQ and CAT total scores from baseline in both studies; improvement in CCQ total score reached significance only in 0126. In pooled data, a greater proportion of patients achieved clinically meaningful response in SGRQ score (≥4-unit decrease from baseline) with revefenacin vs placebo (odds ratio, 1.5; 95% confidence interval, 1.1-2.1; P = 0.012). Clinically meaningful responses were also seen in CAT (≥2-unit decrease from baseline) and CCQ (≥0.4-unit decrease from baseline) scores with revefenacin vs placebo. When stratified by sex, improvements from baseline in SGRQ, CAT, and CCQ scores following revefenacin vs placebo reached statistical significance only in women. CONCLUSIONS Maintenance treatment with revefenacin improved health status in patients with moderate to very severe COPD; however, the effect was more pronounced for women than men. CLINICALTRIALS GOV: NCT02459080; NCT02512510.
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Affiliation(s)
- James F Donohue
- Division of Pulmonary Diseases and Critical Care, Department of Medicine, University of North Carolina School of Medicine, 130 Mason Farm Rd, Chapel Hill, NC, 27514, USA.
| | - Gary T Ferguson
- Pulmonary Research Institute of Southeast Michigan, 29255 W 10 Mile Rd A, Farmington Hills, MI, 48336, USA.
| | - Jill A Ohar
- Department of Internal Medicine, Section of Pulmonary, Critical Care, Allergy and Immunologic Medicine at Wake Forest University School of Medicine, Medical Center Blvd 7th Floor, Winston-Salem, NC, 27157, USA.
| | - David A Lombardi
- Theravance Biopharma US, Inc., 901 Gateway Blvd, South San Francisco, CA, 94080, USA.
| | - Roslyn F Schneider
- Theravance Biopharma US, Inc., 901 Gateway Blvd, South San Francisco, CA, 94080, USA.
| | - Karmon Johnson
- Theravance Biopharma US, Inc., 901 Gateway Blvd, South San Francisco, CA, 94080, USA.
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4
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Alsubheen SA, Beauchamp MK, Ellerton C, Goldstein R, Alison JA, Dechman G, Haines KJ, Harrison SL, Holland AE, Lee AL, Marques A, Spencer L, Stickland M, Skinner EH, Brooks D. Validity of the Activities-specific Balance Confidence Scale in individuals with chronic obstructive pulmonary disease. Expert Rev Respir Med 2022; 16:689-696. [DOI: 10.1080/17476348.2022.2099378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
| | - Marla K. Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Jennifer A. Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax NS, Canada
- Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax NS, Canada
| | | | - Samantha L. Harrison
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Anne E. Holland
- Department of Physiotherapy, Alfred Health, Melbourne VIC, Australia
- Respiratory Research, Monash University, Melbourne VIC, Australia
- Institute for Breathing and Sleep, Melbourne VIC, Australia
| | - Annemarie L. Lee
- Institute for Breathing and Sleep, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
- Department of Allied Health Research, Cabrini Health, Malvern VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, ESSUA) and Institute of Biomedicine, iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown NSW, Australia
| | - Michael Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton AB, Canada
- G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H. Skinner
- Physiotherapy Department, Western Health, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
| | - Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Respiratory Research, Monash University, Melbourne VIC, Australia
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5
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Alsubheen SA, Beauchamp M, Ellerton C, Goldstein R, Alison J, Dechman G, Haines KJ, Harrison S, Holland A, Lee A, Marques A, Spencer L, Stickland M, Skinner EH, Brooks D. Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls. COPD 2022; 19:166-173. [PMID: 35392741 DOI: 10.1080/15412555.2022.2038120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
No previous research has examined age and sex differences in balance outcomes in individuals with chronic obstructive pulmonary disease (COPD) at risk of falls. A secondary analysis of baseline data from an ongoing trial of fall prevention in COPD was conducted. Age and sex differences were analyzed for the Berg Balance scale (BBS), Balance Evaluation System Test (BEST test) and Activities-specific Balance Confidence Scale (ABC). Overall, 223 individuals with COPD were included. Females had higher balance impairments than males [BBS: mean (SD) = 47 (8) vs. 49 (6) points; BEST test: 73 (16) vs. 80 (16) points], and a lower confidence to perform functional activities [ABC = 66 (21) vs. 77 (19)]. Compared to a younger age (50-65 years) group, age >65 years was moderately associated with poor balance control [BBS (r = - 0.37), BEST test (r = - 0.33)] and weakly with the ABC scale (r = - 0.13). After controlling for the effect of balance risk factors, age, baseline dyspnea index (BDI), and the 6-min walk test (6-MWT) explained 38% of the variability in the BBS; age, sex, BDI, and 6-MWT explained 40% of the variability in the BEST test; And BDI and the 6-MWT explained 44% of the variability in the ABC scale. This study highlights age and sex differences in balance outcomes among individuals with COPD at risk of falls. Recognition of these differences has implications for pulmonary rehabilitation and fall prevention in COPD, particularly among females and older adults.
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Affiliation(s)
- Sanaa A Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Samantha Harrison
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Anne Holland
- Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia.,Respiratory Research, Monash University, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Annemarie Lee
- Institute for Breathing and Sleep, Melbourne, VIC, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia.,Centre for Allied Health Research and Education, Cabrini Health, Malvern, VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Michael Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H Skinner
- Physiotherapy Department, Western Health, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia
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6
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Koch M, Hjermstad MJ, Tomaszewski K, Tomaszewska I, Hornslien K, Harle A, Arraras J, Morag O, Pompili C, Ioannidis G, Navarra C, Chie W, Johnson C, Bohrer T, Janssens A, Kulis D, Bottomley A, Schulz C, Zeman F, Koller M. Gender effects on quality of life and symptom burden in patients with lung cancer: results from a prospective, cross-cultural, multi-center study. J Thorac Dis 2020; 12:4253-4261. [PMID: 32944337 PMCID: PMC7475557 DOI: 10.21037/jtd-20-1054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background Lung cancer causes impairment of health-related quality of life (QoL), but little is known about gender aspects in QoL and symptom burden of lung cancer patients. The aim of this study was to investigate gender differences in QoL as assessed by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the updated lung cancer module. Methods In a prospective, international, cross-cultural, multicenter study that was undertaken to update the lung cancer-specific module EORTC QLQ-LC13, patients filled in the core questionnaire EORTC QLQ-C30 and the updated lung cancer module. Gender differences were calculated for all QoL scores using ANCOVAs that controlled for known and suspected confounders. Comparisons with historic data were drawn. Results A total of 200 patients (82 female and 118 male, median age 65 years) were recruited. With the exception of coughing (estimated marginal means: women 33.86 and men 43.52, P=0.022) and diarrhea (estimated marginal means: women 26.01 and men 17.93, P=0.038) there were no significant QoL gender differences. Fatigue was the most pronounced symptom in both, men and women, outpacing typical respiratory symptoms. Quite generally, our sample of lung cancer patients showed considerably worse QoL in all scores when compared to EORTC reference data (lung cancer and combined cancer diagnoses, mean differences up to 13.70 and 21.54 score points, respectively) and to a German norm reference sample (up to 35.37 score points). Conclusions This study adds to the literature in showing that the typical QoL gender difference effect (women doing worse than men) may not be generalizable across all patient samples.
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Affiliation(s)
- Myriam Koch
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Marianne Jensen Hjermstad
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Krzysztof Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Iwona Tomaszewska
- Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Amelie Harle
- Oncology, Poole Hospital NHS Foundation Trust, Poole, UK
| | - Juan Arraras
- Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ofir Morag
- Oncology, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
| | - Cecilia Pompili
- Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | | | - Chiara Navarra
- Psychology, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Weichu Chie
- Graduate Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei
| | - Colin Johnson
- Surgical Unit, University of Southampton, Southampton, UK
| | - Thomas Bohrer
- Thoraxchirurgie, Klinikum Kulmbach, Kulmbach, Germany
| | - Annelies Janssens
- Thoracic Oncology, Universitair Ziekenhuis Antwerpen, Antwerp, Belgium
| | - Dagmara Kulis
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Andrew Bottomley
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
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7
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Cho J, Lee CH, Kim DK, Hwang HG, Kim YI, Choi HS, Park JW, Yoo KH, Jung KS, Lee SD. Impact of gender on chronic obstructive pulmonary disease outcomes: a propensity score-matched analysis of a prospective cohort study. Korean J Intern Med 2020; 35:1154-1163. [PMID: 32098456 PMCID: PMC7487291 DOI: 10.3904/kjim.2019.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/01/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Despite increasing awareness of the burden of chronic obstructive pulmonary disease (COPD) in women, knowledge regarding gender differences in COPD outcomes is limited. Therefore, we aimed to evaluate whether COPD outcomes, including exacerbations, lung function, and symptoms differ by gender. METHODS We recruited patients with COPD from two Korean multicenter prospective cohorts. After propensity score matching, the main outcome, the incidence of moderate or severe exacerbations was analyzed using a negative binomial regression model. We also assessed changes in lung function and symptom scores including the St. George's respiratory questionnaire for COPD (SGRQ-C), COPD assessment test (CAT), and the modified Medical Research Council (mMRC) dyspnea score. RESULTS After propensity score matching, 74 women and 74 men with COPD were included. The incidence rates of exacerbations in women and men were not significantly different (incidence rate ratio, 1.49; 95% confidence interval [CI], 0.88 to 2.54). There was no significant difference in the incidence rates adjusted for medication possession ratios of long-acting muscarinic antagonists, long-acting β-agonists, and inhaled corticosteroids during the follow-up period (incidence rate ratio, 1.47; 95% CI, 0.86 to 2.52). Rates of decline in post-bronchodilator forced expiratory volume in 1 second and forced vital capacity did not differ between women and men during 48 months of follow-up. The changes in scores on the SGRQ-C, CAT, and mMRC Questionnaire in women were also similar to those in men. CONCLUSION We observed no gender differences in the rate of exacerbations of COPD in a prospective longitudinal study. Further studies are needed to confirm these findings in the general COPD population.
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Affiliation(s)
- Jaeyoung Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Correspondence to Chang-Hoon Lee, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea Tel: +82-2-2072-4743, Fax: +82-2-762-9662, E-mail:
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hun-Gyu Hwang
- Division of Respiratory, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Gumi, Korea
| | - Yu-Il Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Hye Sook Choi
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jeong-Woong Park
- Division of Pulmonology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Ki-Suck Jung
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sang-Do Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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8
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Utilization and determinants of use of non-pharmacological interventions in COPD: Results of the COSYCONET cohort. Respir Med 2020; 171:106087. [PMID: 32917358 DOI: 10.1016/j.rmed.2020.106087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Guidelines for chronic obstructive pulmonary disease (COPD) recommend supplementing pharmacotherapy with non-pharmacological interventions. Little is known about the use of such interventions by patients. We analyzed the utilization of a number of non-pharmacological interventions and identified potential determinants of use. METHODS Based on self-reports, use of interventions (smoking cessation, influenza vaccination, physiotherapy, sports program, patient education, pulmonary rehabilitation) and recommendation to use were assessed in 1410 patients with COPD. The utilization was analyzed according to sex and severity of disease. Potential determinants of utilization included demographic variables and disease characteristics and were analyzed using logistic regression models. RESULTS Influenza vaccination in the previous autumn/winter was reported by 73% of patients. About 19% were currently participating in a reimbursed sports program, 10% received physiotherapy, 38% were ever enrolled in an educational program, and 34% had ever participated in an outpatient or inpatient pulmonary rehabilitation program. Out of 553 current or former smokers, 24% had participated in a smoking cessation program. While reports of having received a recommendation to use mainly did not differ according to sex, women showed significantly (p < 0.05) higher utilization rates than men for all interventions except influenza vaccination. Smoking was a predictor for not having received a recommendation for utilization and also significantly associated with a reduced odds of utilization. We found a correlation between recommendation to use and utilization. CONCLUSIONS Utilization of non-pharmacological interventions was lower in men and smokers. A recommendation or offer to use by the physician could help to increase uptake.
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9
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Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study. NPJ Prim Care Respir Med 2019; 29:45. [PMID: 31822681 PMCID: PMC6904454 DOI: 10.1038/s41533-019-0157-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022] Open
Abstract
The present study aimed to generate real-world evidence regarding gender differences among chronic obstructive pulmonary disease (COPD) patients, especially as regards the diagnosis and outcomes in order to identify areas for improvement and management and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients and a matched reference population from 52 primary care centers in 2000–2014. The incidence of COPD, prevalence of asthma and other comorbidities, risk of exacerbations, mortality rate, COPD drug prescriptions, and healthcare resource utilization were analyzed. In total, 17,479 patients with COPD were included in the study. During the study period, COPD was more frequent among women (53.8%) and women with COPD experienced more exacerbations vs. men (6.66 vs. 4.66). However, the overall mortality rate was higher in men compared with women (45% vs. 38%), but no difference for mortality due to COPD was seen between genders over the study period. Women seemed to have a greater susceptibility to asthma, fractures, osteoporosis, rheumatoid arthritis, rhinitis, depression, and anxiety, but appeared less likely to have diabetes, kidney diseases, and cardiovascular diseases. Furthermore, women had a greater risk of COPD-related hospitalization and were likely to receive a significantly higher number of COPD drug prescriptions compared with men. These results support the need to reduce disease burden among women with COPD and highlight the role of healthcare professionals in primary care who should consider all these parameters in order to properly diagnose and treat women with COPD.
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Mesquita CB, Knaut C, Caram LMDO, Ferrari R, Bazan SGZ, Godoy I, Tanni SE. Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year. ACTA ACUST UNITED AC 2019; 44:390-397. [PMID: 30517340 PMCID: PMC6467586 DOI: 10.1590/s1806-37562017000000019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 01/14/2018] [Indexed: 12/13/2022]
Abstract
Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br])
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Affiliation(s)
- Carolina Bonfanti Mesquita
- . Disciplina de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Caroline Knaut
- . Disciplina de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Laura Miranda de Oliveira Caram
- . Disciplina de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Renata Ferrari
- . Disciplina de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Silmeia Garcia Zanati Bazan
- . Disciplina de Cardiologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Irma Godoy
- . Disciplina de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Suzana Erico Tanni
- . Disciplina de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
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Fuentes N, Cabello N, Nicoleau M, Chroneos ZC, Silveyra P. Modulation of the lung inflammatory response to ozone by the estrous cycle. Physiol Rep 2019; 7:e14026. [PMID: 30848106 PMCID: PMC6405886 DOI: 10.14814/phy2.14026] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
Emerging evidence suggests that sex differences exist in the control of lung innate immunity; however, the specific roles of sex hormones in the inflammatory response, and the mechanisms involved are unclear. Here, we investigated whether fluctuations in circulating hormone levels occurring in the mouse estrous cycle could affect the inflammatory response to air pollution exposure. For this, we exposed female mice (C57BL/6J, 8 weeks old) at different phases of the estrous cycle to 2 ppm of ozone or filtered air (FA) for 3 h. Following exposure, we collected lung tissue and bronchoalveolar lavage fluid (BAL), and performed lung function measurements to evaluate inflammatory responses and respiratory mechanics. We found a differential inflammatory response to ozone in females exposed in the luteal phase (metestrus, diestrus) versus the follicular phase (proestrus, estrus). Females exposed to ozone in the follicular phase had significantly higher expression of inflammatory genes, including Ccl2, Cxcl2, Ccl20, and Il6, compared to females exposed in the luteal phase (P < 0.05), and displayed differential activation of regulatory pathways. Exposure to ozone in the follicular phase also resulted in higher BAL neutrophilia, lipocalin levels, and airway resistance than exposure in the luteal phase (P < 0.05). Together, these results show that the effects of ozone exposure in the female lung are affected by the estrous cycle phase, and potentially hormonal status. Future studies investigating air pollution effects and inflammation in women should consider the menstrual cycle phase and/or circulating hormone levels.
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Affiliation(s)
- Nathalie Fuentes
- Department of PediatricsThe Pennsylvania State University College of MedicineHersheyPennsylvania
| | - Noe Cabello
- Department of PediatricsThe Pennsylvania State University College of MedicineHersheyPennsylvania
| | - Marvin Nicoleau
- Department of PediatricsThe Pennsylvania State University College of MedicineHersheyPennsylvania
| | - Zissis C. Chroneos
- Department of PediatricsThe Pennsylvania State University College of MedicineHersheyPennsylvania
| | - Patricia Silveyra
- Department of PediatricsThe Pennsylvania State University College of MedicineHersheyPennsylvania
- Biobehavioral LaboratoryThe University of North Carolina at Chapel HillChapel HillNorth Carolina
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Akiki Z, Hallit S, Layoun N, Cherfane M, Sacre H, Waked M, Salameh P. Validation of the St George's respiratory questionnaire and risks factors affecting the quality of life of Lebanese COPD and asthma patients. J Asthma 2018; 56:1212-1221. [PMID: 30359153 DOI: 10.1080/02770903.2018.1531996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: We aimed to validate the Arabic version of the St George's Respiratory Questionnaire (SGRQ) for use in Lebanese Chronic obstructive pulmonary disease (COPD) and asthma patients and to identify risk factors that might affect the quality of life in these patients. Methods: COPD (n = 90) and asthma patients (n = 124) were recruited from the outpatient clinics of the Pulmonology department of a university hospital and a medical center in Beirut. They filled out a standardized questionnaire. The total SGRQ score and the component scores (symptoms, activity and impacts) were calculated. To confirm the SGRQ validity in the Lebanese population, factor analyses were applied for the whole sample, only asthma and only COPD patients, respectively. The associations between the total SGRQ score and FEV1% predicted, CCQ score and MRC scale were assessed. Multiple linear regression models were used to evaluate the association between the total SGRQ scores and the socio-demographics and the diseases risk factors. Results: COPD patients had a higher SGRQ total and subscales scores compared to asthma patients. A high Cronbach's alpha was found for the whole sample (0.802), only COPD patients (0.833) and only asthma patients (0.734). A significant negative correlation was found between FEV1% predicted and the total SGRQ scores. Occupational exposure, BMI and previous waterpipe smoking were among the factors that significantly and positively influenced a higher SGRQ score. Conclusions: The Lebanese version of the SGRQ emerges as a good health-related quality of life evaluative instrument that is reasonable to be used in COPD and asthma patients in Lebanon.
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Affiliation(s)
- Zeina Akiki
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Nursing and Health Sciences, Notre Dame Louaize University , Barsa , Lebanon.,Faculty of Public Health, Sainte Famille University , Batroun , Lebanon
| | - Souheil Hallit
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) , Jounieh , Lebanon
| | - Nelly Layoun
- School of Pharmacy, Lebanese International University , Beirut , Lebanon
| | - Michelle Cherfane
- Drug Information Center, Order of Pharmacists in Lebanon , Beirut , Lebanon
| | - Hala Sacre
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Medicine, Balamand University, Balamand , Lebanon
| | - Mirna Waked
- Faculty of Pharmacy, Lebanese University , Beirut , Lebanon
| | - Pascale Salameh
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,School of Pharmacy, Lebanese International University , Beirut , Lebanon.,Faculty of Medicine, Lebanese University , Beirut , Lebanon
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Genotype is associated with smoking and other key health behaviors among individuals with alpha-1 antitrypsin deficiency-associated lung disease. Respir Med 2018; 143:48-55. [PMID: 30261992 DOI: 10.1016/j.rmed.2018.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/21/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the association of genotype with smoking and other key health behaviors among individuals with alpha-1 antitrypsin deficiency (AATD) associated lung disease. METHODS Self-reported data were analyzed from 3506 individuals with AATD-associated lung disease. All data were collected upon enrollment in a disease management program designed for individuals who have been prescribed augmentation therapy. Multivariate logistic regression was utilized to examine the extent to which genotype was associated with smoking and other key health behaviors (i.e., getting a pneumonia vaccine, getting a flu vaccine, exercising, and maintaining a healthy weight). We hypothesized that MZs and SZs are more likely than ZZs to be current smokers, and that genotype is associated with additional health behaviors. RESULTS MZs and SZs had higher odds of being a current smoker than ZZs (MZ versus ZZ OR = 2.73, p < .001; SZ versus ZZ OR = 4.34, p < .001). For every additional health behavior examined, MZs had higher odds of unhealthy behavior than ZZs (ORs ranged from 1.35 to 1.98, p < .05). SZs had higher odds of unhealthy behavior than ZZs with regard to lack of exercise (OR = 1.52, p = .003) and failure to maintain a healthy weight (underweight OR = 1.93, p = .028; overweight OR = 1.43, p = .015). CONCLUSIONS Among individuals who have been prescribed augmentation therapy for lung disease due to AATD, genotype is associated with smoking and additional health behaviors that are central to managing lung disease.
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Tabberer M, Gonzalez-McQuire S, Muellerova H, Briggs AH, Rutten-van Mölken MPMH, Chambers M, Lomas DA. Development of a Conceptual Model of Disease Progression for Use in Economic Modeling of Chronic Obstructive Pulmonary Disease. Med Decis Making 2017; 37:440-452. [PMID: 27486218 DOI: 10.1177/0272989x16662009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To develop and validate a new conceptual model (CM) of chronic obstructive pulmonary disease (COPD) for use in disease progression and economic modeling. The CM identifies and describes qualitative associations between disease attributes, progression and outcomes. METHODS A literature review was performed to identify any published CMs or literature reporting the impact and association of COPD disease attributes with outcomes. After critical analysis of the literature, a Steering Group of experts from the disciplines of health economics, epidemiology and clinical medicine was convened to develop a draft CM, which was refined using a Delphi process. The refined CM was validated by testing for associations between attributes using data from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE). RESULTS Disease progression attributes included in the final CM were history and occurrence of exacerbations, lung function, exercise capacity, signs and symptoms (cough, sputum, dyspnea), cardiovascular disease comorbidities, 'other' comorbidities (including depression), body composition (body mass index), fibrinogen as a biomarker, smoking and demographic characteristics (age, gender). Mortality and health-related quality of life were determined to be the most relevant final outcome measures for this model, intended to be the foundation of an economic model of COPD. CONCLUSION The CM is being used as the foundation for developing a new COPD model of disease progression and to provide a framework for the analysis of patient-level data. The CM is available as a reference for the implementation of further disease progression and economic models.
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Affiliation(s)
- Maggie Tabberer
- Value Evidence and Outcomes, GSK R&D, Stockley Park, UK (MT)
| | - Sebastian Gonzalez-McQuire
- Formerly Global Health Outcomes, GSK R&D, Stockley Park, UK (SGM)
- ICON Health Economics, Morristown, NJ, USA (AHB)
| | | | - Andrew H Briggs
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK (AHB)
- ICON Health Economics, Morristown, NJ, USA (AHB)
| | - Maureen P M H Rutten-van Mölken
- Institute for Medical Technology Assessment, Erasmus University/Erasmus Medical Centre, Rotterdam, The Netherlands (MPMHRvM)
| | | | - David A Lomas
- Wolfson Institute for Biomedical Research, University College London, London, UK (DAL)
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Athayde FTS, Vieira DSR, Britto RR, Parreira VF. Functional outcomes in patients with chronic obstructive pulmonary disease: a multivariate analysis. Braz J Phys Ther 2014; 18:63-71. [PMID: 24675914 PMCID: PMC4183240 DOI: 10.1590/s1413-35552012005000142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 09/20/2013] [Indexed: 11/21/2022] Open
Abstract
Background Multiple factors can influence the severity of chronic obstructive pulmonary
disease (COPD) and the functioning of patients with COPD, such as personal
characteristics and systemic manifestations. Objective To evaluate the different factors that can influence the activity and
psychosocial impact domains of the Saint George's Respiratory Questionnaire
(SGRQ) in COPD patients. Method Participants, recruited in a university-based hospital, responded to the
SGRQ, and in addition, personal, anthropometric, and clinical data were
collected. The study was approved by the Institutional Ethics Committee.
Data were analyzed using multiple linear regression models, with the SGRQ
activity and psychosocial impact scores as outcome variables, and 10
explanatory variables (age, gender, forced expiratory volume in the first
second - FEV1, smoking load, body mass index, oxygen therapy,
associated diseases, regular physical activity, participation in a formal
rehabilitation program, and SGRQ symptoms score) were considered. Results The best regression model for predicting the SGRQ activity score
(r2=0.477) included gender, FEV1, and SGRQ
symptoms. In contrast, the predictive model with the highest proportion of
explained variance in psychosocial impact score (r2=0.426)
included the variables gender, oxygen therapy, and SGRQ symptoms. Conclusions The results indicate that the outcomes, while based on functioning parameters
in COPD patients, could be partly explained by the personal and clinical
factors analyzed, especially by the symptoms assessed by the SGRQ. Thus, it
appears that the health conditions of these patients cannot be described by
isolated variables, including pulmonary function parameters.
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Affiliation(s)
| | | | - Raquel R Britto
- Physical Therapy Department, UFMG, Belo Horizonte, MG, Brazil
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Athanazio R. Airway disease: similarities and differences between asthma, COPD and bronchiectasis. Clinics (Sao Paulo) 2012; 67:1335-43. [PMID: 23184213 PMCID: PMC3488995 DOI: 10.6061/clinics/2012(11)19] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 09/27/2012] [Indexed: 11/18/2022] Open
Abstract
Airway diseases are highly prevalent worldwide; however, the prevalence of these diseases is underestimated. Although these diseases present several common characteristics, they have different clinical outcomes. The differentiation between asthma, chronic obstructive pulmonary disease and bronchiectasis in the early stage of disease is extremely important for the adoption of appropriate therapeutic measures. However, because of the high prevalence of these diseases and the common pathophysiological pathways, some patients with different diseases may present with similar symptoms. The objective of this review is to highlight the similarities and differences between these diseases in terms of the risk factors, pathophysiology, symptoms, diagnosis and treatment.
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Affiliation(s)
- Rodrigo Athanazio
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Heart Institute (InCor), Pulmonary Division, São Paulo, SP, Brazil.
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Ou CY, Chen CZ, Lee CH, Lin CC, Chang HY, Hsiue TR. Pulmonary function change in patients with Sauropus androgynus-related obstructive lung disease 15 years later. J Formos Med Assoc 2012; 112:630-4. [PMID: 24120153 DOI: 10.1016/j.jfma.2012.07.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 07/29/2012] [Accepted: 07/30/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE Little is understood about the clinical course and prognosis of patients with Sauropus androgynus-related obstructive lung disease. The aim of this study was to investigate their clinical manifestations and pulmonary function change 15 years after the acute episode. METHODS A descriptive, observational study of patients with S androgynus-related obstructive lung disease, diagnosed 15 years ago, was conducted. We evaluated their pulmonary function and the Modified Medical Research Council (MMRC) dyspnea scale. Saint George's Respiratory Questionnaire (SGRQ) was also performed. Age- and forced expiratory volume in one second (FEV1)-matched chronic obstructive pulmonary disease (COPD) patients were used as a reference group for comparison of clinical manifestations. RESULTS Twenty-nine of 49 patients, diagnosed at our hospital 15 years ago, could be contacted. Four patients died and one patient was ventilator-dependent. Sixteen patients were willing to come to our hospital to have pulmonary function and questionnaire evaluation. The FEV1 of these patients declined only 1.6 ± 21.6 mL/year over a 15-year period. Meanwhile, the severity of their dyspnea and their health-related quality of life were better than age- and FEV1-matched COPD patients as shown by the MMRC dyspnea scale (1.4 ± 0.8 vs. 2.0 ± 1.0; p = 0.037) and symptom domain of the SGRQ (32.6 ± 18.4 vs. 43.5 ± 20.3; p = 0.006). CONCLUSION After an acute deterioration, patients with S androgynus-related obstructive lung disease had a stationary pulmonary function over a period of 15 years, and their clinical manifestations were less severe than age- and FEV1-matched COPD patients. A further study with a larger sample size may be needed to confirm these findings.
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Affiliation(s)
- Chih-Ying Ou
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Patel KK, Caramelli B, Gomes A. A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press. Clinics (Sao Paulo) 2011; 66:2159-68. [PMID: 22189744 PMCID: PMC3226614 DOI: 10.1590/s1807-59322011001200024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 11/07/2011] [Indexed: 11/21/2022] Open
Abstract
Recent original scientific contributions published in selected Brazilian periodicals and classifiable under cardiovascular and pulmonary subject categories cover a wide range of sub specialties, both clinical and experimental. Because they appear in journals with only recently enhanced visibility, we have decided to highlight a number of specific items appeared in four Brazilian journals, because we understand that this is an important subsidy to keep our readership adequately informed. These papers cover extensive sub-areas in both fields.
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