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Top results for copd exacerbations

1. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

of Bias Appendix F. Results From Included Studies Appendix G. Results by Severity Appendix H. Adverse Events Appendix I. Inclusion and Exclusion Criteria of Included Studies Appendix J. Sensitivity Analysis Appendix K. Appendix References ES-1 Evidence Summary Background and Objectives Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by airflow limitation and chronic respiratory symptoms. The global prevalence is estimated to be greater than 10 percent (...) of experiencing exacerbations of COPD (ECOPD). There have been various definitions of what constitutes an ECOPD. The Global Initiative for chronic obstructive lung disease (GOLD) defines ECOPD in its 2019 report as “acute worsening of respiratory symptoms that result in additional therapy.” 5 ECOPD is generally characterized by increased dyspnea, increased frequency and severity of cough, and/or increased sputum production. 6 ECOPD is a leading independent cause of increased mortality and morbidity among

2019 Effective Health Care Program (AHRQ)

2. Prevention of Acute Exacerbations of COPD

studies, prospective studies, retrospective studies • Acute exacerbationsCOPD, chronic obstructive lung disease, emphysema, chronic bronchitis, lung diseases (obstructive) • Chronic disease management, prevention • Nonpharmacologic therapies, education • Self-management • Case management • Action plans • In-home monitoring • Tele-intervention, telehealth, tele-health, Ehealth, e-health, telehealthcare, telecare, telemedicine, tele-monitoring, Emedicine, telecommunications and medicine, teleconsult (...) of acute exacerbations of COPD together with improved health- related quality of life, reduced dyspnea, less rescue medication use, and improved lung function and a relatively lower value on the risks and consequences of oral candidiasis, upper respiratory tract infections, and pneumonia. 22. For patients with stable moderate to very severe COPD, we recommend maintenance combination inhaled corticosteroid/long-acting b 2 -agonist therapy compared with inhaled corticosteroid monotherapy to prevent acute

2015 American College of Chest Physicians

3. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline

on the management of #COPD exacerbations from @ERStalk and @atscommunity Executive summary Chronic obstructive pulmonary disease (COPD) exacerbations are episodes of increased respiratory symptoms, particularly dyspnoea, cough and sputum. The European Respiratory Society (ERS) and American Thoracic Society (ATS) collaborated to develop guidelines that address questions regarding the treatment of COPD exacerbations that are not clearly answered by current guidelines. Key recommendations from the guidelines (...) recommendation, very low quality of evidence). Introduction The chronic and progressive course of chronic obstructive pulmonary disease (COPD) is often punctuated by “exacerbations”, defined clinically as episodes of increasing respiratory symptoms, particularly dyspnoea, cough and sputum production, and increased sputum purulence. COPD exacerbations have a negative impact on the quality of life of patients with COPD [ , ], accelerate disease progression, and can result in hospital admissions and death

2017 European Respiratory Society

4. COPD exacerbation: no systematic use of antibiotics

of moderate aggravation in patients with chronic obstructive pulmonary disease (COPD), it is preferable to prescribe antibiotics as a first-line treatment only when the suspicion of bacterial infection is reinforced by an increase in sputum purulence. Patients with chronic obstructive pulmonary disease (COPD) are subject to exacerbations of their disease, i.e. episodes of prolonged aggravation. The known causes are mainly viral and bacterial infections. Some exacerbations justify hospitalisation: severe (...) COPD, rapid increase in respiratory signs, presence of associated diseases (e.g. diabetes, cardiovascular diseases). When exacerbation is moderate, the results of available trials show that seven out of ten patients recover in less than four weeks without antibiotics. About one in ten patients heals faster with antibiotic therapy, which may also extend the interval until the next exacerbation. Antibiotic therapies expose patients to the carrying of resistant bacteria, which are sources of harder

2019 Prescrire

5. 2014 CHEST-CTS Guideline: Prevention of Acute Exacerbation of COPD

, and Schering-Plough. He holds Fiduciary Positions with the American College of Chest Physicians, the Chest Foundation, and the Lung Health Institute of Canada. RAM - no disclosure JO – no disclosure JDR – no disclosure MKS - no disclosure INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common disease with substantial associated morbidity and mortality. Patients with COPD usually have a progression of airflow obstruction that is not fully reversible and can lead to a history of progressive (...) efforts to make this guideline a current and valuable addition to the management of the COPD patient. REFERENCES 1 Global strategy for the diagnosis, management n prevention of chronic obstructive pulmonary disease. Updated 2103.http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Fe b20.pdf. 2 Brusasco V. Reducing cholinergic constriction: the major reversible mechanism in COPD. European Respiratory Review 2006; 15:32-36 3 Cooper CB. Airflow obstruction and exercise. Respir Med 2009; 103:325

2014 Canadian Thoracic Society

7. Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing

implications 24 Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24This guideline should be read in conjunction with NG115. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce (...) antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. See the NICE guideline on COPD in over 16s for other recommendations on preventing and managing an acute exacerbation of COPD, including self-management. Who is it for? Health professionals People with COPD, their families and carers Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

8. COPD exacerbations

exacerbations : a European Respiratory Society/American Thoracic Society guideline Jadwiga A. Wedzicha (ERS co-chair) , Marc Miravitlles , John R. Hurst , Peter M.A (...) of chronic obstructive pulmonary disease ( COPD ) exacerbations . Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach (...) Week 08, Ovid 2011 12. Management of COPD exacerbations : a European Respiratory Society/American Thoracic Society guideline. This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease ( COPD ) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development

2018 Trip Latest and Greatest

9. Management of COPD Exacerbations: An Official ERS/ATS Clinical Practice Guideline

should be reconsidered as new evidence becomes available. Copyright ©ERS 2017 https://doi.org/10.1183/13993003.00791-2016 Eur Respir J 2017; 49: 1600791 TASK FORCE REPORT ERS/ATS GUIDELINEIntroduction The chronic and progressive course of chronic obstructive pulmonary disease (COPD) is often punctuated by “exacerbations”, defined clinically as episodes of increasing respiratory symptoms, particularly dyspnoea, cough and sputum production, and increased sputum purulence. COPD exacerbations have (...) -2016]. ABSTRACT This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force’s questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed

2017 American Thoracic Society

10. Do antibiotics improve outcomes for patients hospitalized with COPD exacerbations?

Format Metadata Abstract Antibiotic use reduced mortality and treatment failure in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD) (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Giving antibiotics early to hospitalized patients decreased the need for later ventilation and readmission within 30 days for exacerbation of COPD (SOR: B, a retrospective cohort study). URI Citation Journal of Family Practice (...) Do antibiotics improve outcomes for patients hospitalized with COPD exacerbations? Do antibiotics improve outcomes for patients hospitalized with COPD exacerbations? Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Do antibiotics improve outcomes for patients hospitalized with COPD exacerbations? View/ Open Date 2012-09

2018 Clinical Inquiries

11. Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost-Effectiveness and Budget Impact Analysis

, actual cost savings largely depend on the expansion of current PR capacity in Ontario. Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost-Effectiveness and Budget Impact Analysis. February 2015; pp. 1-47 6 PLAIN LANGUAGE SUMMARY Chronic obstructive pulmonary disease (COPD) is a lung disease that causes worsening breathlessness. The symptoms fluctuate from stable to flare-ups that might need hospital care. Pulmonary rehabilitation (PR) is a key (...) ratio LHIN Local Health Integration Network OHTAC Ontario Health Technology Advisory Committee PATH Programs for Assessment of Technology in Health PR Pulmonary rehabilitation PSA Probabilistic sensitivity analysis RCT Randomized controlled trial RT Respiratory therapist SGRQ St. George’s Respiratory Questionnaire THETA Toronto Health Economics and Technology Assessment Collaborative Pulmonary Rehabilitation for Postacute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Cost

2015 Health Quality Ontario

12. Executive Summary: Prevention of Acute Exacerbation of COPD

is not well documented, COPD is underdiagnosed, and the rate of hospitaliza- tion due to COPD is increasing. 11 Exacerbations are to COPD what myocardial infarctions are to coronary artery disease: Th ey are acute, trajectory- changing, and oft en deadly manifestations of a chronic disease. Exacerbations cause frequent hospital admis- sions, relapses, and readmissions 12 ; contribute to death during hospitalization or shortly thereaft er 12 ; r e d uce quality of life dramatically 12 , 13 ; consume fi (...) - erbations of COPD together with improved health-related quality of life, reduced dyspnea, less rescue medication use, and improved lung function and a relatively lower value on the risks and consequences of oral candidiasis, upper respiratory tract infections, and pneumonia. 22. For patients with stable moderate to very severe COPD, we recommend maintenance combination inhaled corticosteroid/long-acting b 2 -agonist therapy compared with inhaled corticosteroid monotherapy to prevent acute exacerbations

2015 American College of Chest Physicians

13. Does Telehealth Monitoring Identify Exacerbations of Chronic Obstructive Pulmonary Disease and Reduce Hospitalisations? An Analysis of System Data Full Text available with Trip Pro

Does Telehealth Monitoring Identify Exacerbations of Chronic Obstructive Pulmonary Disease and Reduce Hospitalisations? An Analysis of System Data The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured (...) during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD.The aim was to undertake the first analysis of system data to determine whether telehealth monitoring can identify an exacerbation of COPD, providing clinicians with an opportunity to intervene with timely treatment and prevent hospital readmission.A total of 23 participants received a telehealth-supported intervention

2017 JMIR medical informatics Controlled trial quality: uncertain

14. Oral steroids are just as effective as intravenous steroids in acute exacerbations of COPD

COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; ICU, intensive care unit; ITU, intensive treatment unit. Clinical Bottom Line In line with NICE guidelines, oral steroids should be given to patients with acute exacerbations of COPD in the absence of any contraindications. Level of Evidence Level 1 - Recent well-done systematic review was considered or a study of high quality is available. References de Jong YP, Uil SM, Grotjohan (...) MEDLINE 1948 to Feb Week 4 2011 with the following search strategy ((COPD OR coad).af OR (‘chronic obstructive’ adj3 disease).af) AND (steroid.af) AND (intravenous.af OR oral.af) AND ((acute OR emergen$ OR urgen$ OR decompensat$ OR sudden).af) Search Outcome One-hundred and seventy-four papers were found, of which two were considered relevant to the three-part question. Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses de Jong

2011 BestBETS

15. CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions (Abstract)

CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions The role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (COPD) is controversial and a biomarker identifying patients who benefit from antibiotics is mandatory. We performed a randomised, controlled trial in patients with acute exacerbations of COPD, comparing C-reactive protein (CRP)-guided antibiotic treatment to patient reported symptoms in accordance with the Global (...) Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, in order to show a reduction in antibiotic prescription.Patients hospitalised with acute exacerbations of COPD were randomised to receive antibiotics based either on the GOLD strategy or according to the CRP strategy (CRP ≥50 mg·L-1).In total, 101 patients were randomised to the CRP group and 119 to the GOLD group. Fewer patients in the CRP group were treated with antibiotics compared to the GOLD group (31.7% versus 46.2%, p=0.028; adjusted

2019 EvidenceUpdates

16. Effects of Nasal High-flow Oxygen in Patients With an Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

studies show that patients with low blood oxygen levels who use HFNC oxygen have lower rates of needing mechanical ventilation. Condition or disease Intervention/treatment Phase Chronic Obstructive Pulmonary Disease Device: Nasal high flow Not Applicable Detailed Description: Patients admitted to the hospital with an exacerbation of COPD accompanied by respiratory failure need supplemental oxygen and alleviation of an increased work of breathing. Patients with acute exacerbations of COPD have (...) Effects of Nasal High-flow Oxygen in Patients With an Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Effects of Nasal High-flow Oxygen in Patients With an Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2017 Clinical Trials

17. Oscillating Positive Expiratory Pressure Devices and Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Hesham Raafat, Ain Shams University: COPD acute exacerbation OPEP Additional relevant MeSH terms: Layout table for MeSH terms Lung Diseases Pulmonary Disease, Chronic Obstructive Chronic Disease Respiratory Tract Diseases Lung Diseases, Obstructive Disease Attributes Pathologic Processes (...) hospital stay. oscillating positive expiratory pressure (OPEP) devices were extensively studied in cystic fibrosis and bronchiectasis. Only seldom studied in chronic bronchitis. This study aims to measure the effects of mucous clearing device in hospitalized patients with acute exacerbation of COPD. Condition or disease Intervention/treatment Phase Pulmonary Disease, Chronic Obstructive Device: OPEP Aerobika Device: OPEP Aerobika Sham device Not Applicable Detailed Description: In this study

2017 Clinical Trials

18. Use of dry powder inhalers in acute exacerbations of asthma and COPD Full Text available with Trip Pro

in acute exacerbations of asthma and COPD. Therapeutic Advances in Respiratory Disease 2009; 3(2): 81-91 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Adrenergic beta-Agonists /administration & Albuterol /administration & Asthma /drug therapy /physiopathology; Bronchodilator Agents /administration & Disease Progression; Ethanolamines /administration & Formoterol Fumarate; Humans; Nebulizers and Vaporizers; Pulmonary Disease, Chronic Obstructive /drug therapy (...) Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Selroos O, Borgstrom L, Ingelf J CRD summary This review concluded that dry powder inhalers functioned equally as well as established therapies with other inhaler devices in patients with acute asthma or chronic obstructive pulmonary disease. Given poor reporting of the review process

2009 DARE.

19. In-Hospital Physiotherapy for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD)

or S2 or S3 or S5 Search modes - Boolean/Phrase 9484 Inhospital Physiotherapy for AECOPD: A Rapid Review. January 2013; pp. 1–28. 23 S5 chronic bronchitis or emphysema Search modes - Boolean/Phrase 1880 S4 (MH "Emphysema+") Search modes - Boolean/Phrase 1189 S3 copd or coad Search modes - Boolean/Phrase 5022 S2 (chronic obstructive and (lung* or pulmonary or airway* or airflow or respiratory) and (disease* or disorder*)) Search modes - Boolean/Phrase 7495 S1 (MH "Pulmonary Disease, Chronic (...) Inhospital Physiotherapy for AECOPD: A Rapid Review. January 2013; pp. 1–28. 20 Cochrane Library ID Search Hits #1 MeSH descriptor: [Pulmonary Disease, Chronic Obstructive] explode all trees 1838 #2 chronic near/2 obstructive near/2 (lung* or pulmonary or airway* or airflow or respiratory) next (disease* or disorder*):ti,ab,kw OR copd or coad:ti,ab,kw OR chronic airflow obstruction:ti,ab,kw 7234 #3 MeSH descriptor: [Emphysema] explode all trees 92 #4 (chronic near/2 bronchitis) or emphysema:ti,ab,kw 1932

2013 Health Quality Ontario

20. Acute exacerbation of chronic obstructive pulmonary disease

) and/or diarrhoea, including Clostridium difficile -associated diarrhoea (associated with the use of antibiotics). Definition Chronic obstructive pulmonary disease (COPD) is "a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases." Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis (...) , management and prevention of chronic obstructive pulmonary disease. November 2017 [internet publication] http://goldcopd.org/gold-reports/ An exacerbation of COPD may be defined as "an acute worsening of respiratory symptoms that results in additional therapy." Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. November 2017 [internet publication] http://goldcopd.org/gold-reports/ History and exam

2018 BMJ Best Practice