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Top results for copd

41. Capturing Exacerbations of Chronic Obstructive Pulmonary Disease with EXACT. A Subanalysis of FLAME Full Text available with Trip Pro

Capturing Exacerbations of Chronic Obstructive Pulmonary Disease with EXACT. A Subanalysis of FLAME Chronic obstructive pulmonary disease exacerbations accelerate lung function decline, reduce quality of life, and increase mortality. A subset of patients (n = 457) from the FLAME (Effect of Indacaterol Glycopyrronium vs. Fluticasone Salmeterol on COPD Exacerbations) study used the Exacerbations of COPD Tool (EXACT) to capture symptom-defined exacerbations.To evaluate the effect of indacaterol

2019 EvidenceUpdates

42. Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Full Text available with Trip Pro

Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally (...) , quality of death and dying was assessed in patients who died during 2-year follow-up.A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.165 patients were

2019 EvidenceUpdates

43. Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India. Full Text available with Trip Pro

Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India. Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may (...) at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included.There could be a key role for pharmacists as educators for COPD patients

2019 PharmacoEconomics - open Controlled trial quality: uncertain

44. Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial. Full Text available with Trip Pro

Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial. Physical exercise can improve patient outcomes and reduce hospitalization and mortality rates among subjects with chronic obstructive pulmonary disease. This study aimed to compare the effects of upper limb and breathing exercises on six-minute walking distance among these patients.This three (...) significant (p > 0.05).Upper limb exercise is more effective than breathing exercise in increasing walking distance among patients with chronic obstructive pulmonary disease. Therefore, upper limb exercise can be used as a safe, simple, and inexpensive rehabilitation technique for these patients.

2019 Advances in respiratory medicine Controlled trial quality: uncertain

45. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: a randomised controlled proof-of-concept trial. Full Text available with Trip Pro

Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: a randomised controlled proof-of-concept trial. The APPLE COPD-ICON2 trial is a prospective 2×2 factorial, double-blinded proof-of-concept randomised controlled trial targeting patients with chronic obstructive pulmonary disease (COPD) without prior history of cardiovascular disease. The primary goal of this trial is to investigate if treatment with antiplatelet (...) recruited with mean age of 67.5 years; 47.5% patients were male. The per-protocol ASPI test response rate to aspirin was 68.3% (95% CI 52.3-80.9%). The per-protocol ADP test response rate to ticagrelaor was 68.8% (95% CI 50.4-82.6%). Platelet response to antiplatelet therapy with aspirin and ticagrelor was not observed in nearly one-third of COPD patients without prior history of cardiovascular disease. These findings support the high pro-thrombotic milieu and the need for further research to determine

2019 ERJ open research Controlled trial quality: predicted high

46. 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 (...) amoxicillin is not appropriate. Whether or not antibiotic treatment is chosen, patient monitoring is useful during the first few days to detect any aggravation that warrants a change in treatment. ©Prescrire 1 January 2019 Share Share Download the full review. See also: Chronic obstructive pulmonary disease. Useful medications for patients with recurrent symptoms Prescrire Int 2016 ; 25 (176) : 272-27 | | | Prescrire Your change of address has been received and will be processed promptly

2019 Prescrire

47. Revefenacin (Yupelri) - To treat patients with chronic obstructive pulmonary disease (COPD)

Revefenacin (Yupelri) - To treat patients with chronic obstructive pulmonary disease (COPD) Drug Approval Package: Yupelri (revefenacin) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Yupelri (revefenacin) Company: Theravance Biopharma Ireland Limited Application Number: 210598 Approval Date: 11/09/2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling

2019 FDA - Drug Approval Package

48. Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department Full Text available with Trip Pro

Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department The Ottawa chronic obstructive pulmonary disease (COPD) Risk Scale (OCRS), which consists of 10 criteria, was previously derived to identify patients in the emergency department with COPD who were at high risk for short-term serious outcomes. We sought to validate, prospectively and explicitly, the OCRS when applied by physicians in the emergency (...) department.We conducted this prospective cohort study involving patients in the emergency departments at 6 tertiary care hospitals and enrolled adults with acute exacerbation of COPD from May 2011 to December 2013. Physicians evaluated patients for the OCRS criteria, which were recorded on a data form along with the total risk score. We followed patients for 30 days and the primary outcome, short-term serious outcomes, was defined as any of death, admission to monitored unit, intubation, noninvasive

2019 EvidenceUpdates

49. Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease - NICE CKS Share Chronic obstructive pulmonary disease - Summary Chronic obstructive pulmonary disease (COPD) is a treatable (but not curable) and largely preventable lung disease. COPD is characterized by airflow obstruction which is usually progressive, and not fully reversible. Tobacco smoking is the major risk factor for the development of COPD. Complications include disability and reduced quality of life (...) cigarette smoke, but also from environmental and occupational exposures [ ]. COPD is the preferred term for chronic bronchitis, emphysema, or chronic obstructive airways disease [ ]. Prevalence and incidence How common is it? In the UK, it is estimated that more than 3 million people currently have chronic obstructive pulmonary disease (COPD), with the disease being undiagnosed in about 2 million of these people. The incidence of COPD is difficult to determine because symptoms usually develop

2019 NICE Clinical Knowledge Summaries

50. A randomised controlled trial to investigate the use of high-frequency airway oscillations as training to improve dyspnoea in COPD. Full Text available with Trip Pro

A randomised controlled trial to investigate the use of high-frequency airway oscillations as training to improve dyspnoea in COPD. Chronic obstructive pulmonary disease (COPD) is characterised by expiratory flow limitation resulting in symptomatic dyspnoea, sputum retention and ventilation heterogeneity. Changes in breathing mechanics affect the ability of respiratory muscles to respond to the ventilatory demands, increasing the sensation of dyspnoea. A high-frequency airway oscillating device (...) and oscillations for combined training. Those receiving the sham device will follow the same protocol; however, the mechanism of action will be removed from the device. Improvements in the Chronic Respiratory Questionnaire-Dyspnoea domain will be the primary outcome measure. Secondary outcomes will explore respiratory muscle function, health-related quality of life, exercise capacity and physical activity. The Lung Clearance Index will be an exploratory outcome. Outcomes will be explored using the most

2019 ERJ open research Controlled trial quality: predicted high

51. Fluticasone furoate/umeclidinium/vilanterol (COPD) - Benefit assessment according to §35a Social Code Book V

. The responsibility for the contents of the dossier assessment lies solely with IQWiG. IQWiG employees involved in the dossier assessment: ? Helmut Hörn ? Katharina Hirsch ? Michaela Florina Kerekes ? Ulrike Lampert ? Min Ripoll ? Cornelia Rüdig ? Carolin Weigel ? Beate Wieseler Keywords: fluticasonfuroat, umeclidinium, vilanterol, pulmonary diseasechronic obstructive, benefit assessment, NCT02164513, NCT02345161 Extract of dossier assessment A18-79 Version 1.0 Fluticasone furoate/umeclidinium/vilanterol (COPD (...) by the pharmaceutical company (hereinafter referred to as the “company”). The dossier was sent to IQWiG on 15 November 2018. Research question The aim of this report is to assess the added benefit of FF/UMEC/VI as maintenance therapy compared with the appropriate comparator therapy (ACT) in adults with moderate to severe chronic obstructive pulmonary disease (COPD) who are inadequately controlled with a combination of a long-acting beta-2 sympathomimetic (LABA) and a long-acting muscarinic receptor antagonist (LAMA

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

52. Temporal Trends Of Pharmacologic Therapies For Patients With Chronic Obstructive Pulmonary Disease In Alberta, Canada Full Text available with Trip Pro

Temporal Trends Of Pharmacologic Therapies For Patients With Chronic Obstructive Pulmonary Disease In Alberta, Canada Temporal Trends Of Pharmacologic Therapies For Patients With Chronic O | COPD Javascript is currently disabled in your browser. Several features of this site will not function whilst javascript is disabled. open access to scientific and medical research Journal Email Alerts About Dove Press Open access peer-reviewed scientific and medical journals. Open Access Dove Medical Press (...) Correspondence: Dat T Tran Institute of Health Economics, #1200 – 10405 Jasper Avenue, Edmonton, Alberta T5J 3N4, Canada Tel +1 780 448 4881 Fax +1 780 448 0018 Email dttran@ualberta.ca Objectives: To describe the trends in pharmacologic treatment for patients newly diagnosed with chronic obstructive pulmonary disease (COPD) in Alberta, Canada. Methods: We linked Alberta health databases to identify patients aged ≥35 years with incident COPD between April 2010 and March 2017. Incident cases were defined

2019 Institute of Health Economics

53. 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

54. Chronic obstructive pulmonary disease in over 16s: diagnosis and management

recommendations 1.2.11 to 1.2.14) they do not smoke they can complete a 6-minute walk distance of at least 140 m (if limited by breathlessness). [2018] [2018] 1.2.85 At the respiratory review, refer the person with COPD to a lung volume reduction multidisciplinary team to assess whether lung volume reduction surgery or endobronchial valves are suitable if they have: hyperinflation, assessed by lung function testing with body plethysmography and and Chronic obstructive pulmonary disease in over 16s: diagnosis (...) 53 Oral prophylactic antibiotic therapy 54 Long-term oxygen therapy 55 Ambulatory and short-burst oxygen therapy 56 Managing pulmonary hypertension and cor pulmonale 57 Lung volume reduction procedures, bullectomy and lung transplantation 58 Risk factors for COPD exacerbations 59 Self-management, education and telehealth monitoring 60 Context 62 Finding more information and resources 63 Update information 64 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) ©

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

55. Randomised controlled trial of cognitive behavioural therapy in COPD Full Text available with Trip Pro

Randomised controlled trial of cognitive behavioural therapy in COPD Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective. Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were measured at baseline, 3, 6 and 12 months. A cost-effectiveness analysis (...) Subscale was 1.52, 95% CI 0.49-2.54, p=0.003). Importantly, the CBT intervention was more cost-effective than leaflets at 12 months, significantly lowering hospital admissions and attendance at emergency departments. CBT delivered by respiratory nurses is a clinically and cost-effective treatment for anxiety in patients with COPD relative to self-help leaflets.

2018 ERJ open research Controlled trial quality: uncertain

56. COPD

COPD COPD - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  COPD Last reviewed: February 2019 Last updated: November 2018 Summary Progressive disease state characterised by airflow limitation that is not fully reversible. Suspected in patients with a history of smoking, occupational and environmental risk factors, or a personal or family history of chronic lung disease. Presents with progressive shortness of breath, wheeze, cough, and sputum production, including haemoptysis (...) characterised by airflow limitation that is not fully reversible. It encompasses both emphysema and chronic bronchitis. The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases. It is primarily caused by cigarette smoking. Although COPD affects the lungs, it also has significant systemic consequences. Exacerbations and comorbidities are important contributors to the overall condition and prognosis in individual patients

2018 BMJ Best Practice

57. Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbations have high rehospitalization rates and reduced quality of life.To evaluate a hospital-initiated program that combined transition and long-term self-management support for patients hospitalized due to COPD (...) by the St George's Respiratory Questionnaire (SGRQ) at 6 months after discharge (score, 0 [best] to 100 [worst]; 4-point difference is clinically meaningful).Among 240 patients who were randomized (mean [SD] age, 64.9 [9.8] years; females, 61.7%), 203 (85%) completed the study. The mean (SD) baseline SGRQ score was 63.1 (19.9) in the intervention group and 62.6 (19.3) in the usual care group. The mean number of COPD-related acute care events per participant at 6 months was 0.72 (95% CI, 0.45-0.97

2018 JAMA Controlled trial quality: predicted high

58. Association of low income with pulmonary disease progression in smokers with and without chronic obstructive pulmonary disease Full Text available with Trip Pro

Association of low income with pulmonary disease progression in smokers with and without chronic obstructive pulmonary disease Low socioeconomic status has been associated with chronic obstructive pulmonary disease (COPD) but little is known about its impact on disease progression. We assessed the association of income to symptoms, pulmonary disease severity and progression in smokers with and without COPD. The COPDGene cohort of 4826 smokers who reported annual income in phase 2 was analysed (...) the effects of race and current smoking is an important factor for disease progression. Worldwide, poverty and its consequences: associated respiratory exposures, limited healthcare access, and inadequate education about smoking risks, may exacerbate chronic lung disease.

2018 ERJ open research

59. Azithromycin treatment modifies airway and blood gene expression networks in neutrophilic COPD Full Text available with Trip Pro

Azithromycin treatment modifies airway and blood gene expression networks in neutrophilic COPD Long-term, low-dose azithromycin reduces exacerbation frequency in chronic obstructive pulmonary disease (COPD), yet the mechanism remains unclear. This study characterised genome-wide gene expression changes in patients with neutrophilic COPD following long-term, low-dose azithromycin treatment. Patients with neutrophilic COPD (>61% or >162×104 cells per mL sputum neutrophils) were randomised (...) of genes regulating antigen presentation, interferon and T-cell responses, and numerous inflammatory pathways in the airways and blood of neutrophilic COPD patients.

2018 ERJ open research Controlled trial quality: uncertain

60. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE) Full Text available with Trip Pro

to 15% (P < 0.001). ΔEBV-SoC at 12 months was statistically and clinically significant: for FEV1, 0.106 L (P < 0.001); 6-minute-walk distance, +39.31 m (P = 0.002); and St. George's Respiratory Questionnaire, -7.05 points (P = 0.004). Significant ΔEBV-SoC were also observed in hyperinflation (residual volume, -522 ml; P < 0.001), modified Medical Research Council Dyspnea Scale (-0.8 points; P < 0.001), and the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (-1.2 (...) A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE) This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months.To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe.Subjects were enrolled with a 2

2018 EvidenceUpdates