Chron Respir Dis [JOURNAL]
Sun
200 papers
Patient and healthcare professional perspectives on telehealth in the care of interstitial lung disease.
Deshpande S, Tikellis G, Barnes H … +4 more , Symons K, Holland AE, Glaspole I, Khor YH
Chron Respir Dis · 2025 · PMID 40820323 · Full text
BackgroundWhile telehealth has been used for specialist care during the COVID-19 pandemic, its benefits and barriers to use for delivering care in interstitial lung disease (ILD) remain unclear. We aimed to explore persp...
BackgroundWhile telehealth has been used for specialist care during the COVID-19 pandemic, its benefits and barriers to use for delivering care in interstitial lung disease (ILD) remain unclear. We aimed to explore perspectives of patients and healthcare professionals (HCPs) towards telehealth use in ILD.MethodThis qualitative study using semi-structured interviews was undertaken in 18 patients with ILD from a single quaternary ILD centre and 18 HCPs of four different disciplines from various ILD centres around Australia. Interviews were transcribed verbatim and coded by two investigators independently using thematic analysis. Themes were developed by consensus.ResultsPatients and HCPs had experienced telehealth via video and telephone, predominantly for teleconsultation and/or telerehabilitation. For patients, benefits included provision of ongoing access to healthcare and significant reduction in travel. Healthcare professionals reported teleconsultations played an important role in patient follow-up rather than at initial contact. Concerns of suboptimal rapport and communication and a lack of physical examination were raised by both groups. Individual patient suitability, improvement in technological platform and support, and improved workflow for clinicians were important factors for utilisation of telehealth. Patients were open to the use of home monitoring devices, however, HCPs felt further research was required prior to clinical implementation.ConclusionThis study highlights positive and negative experiences of telehealth for patients and HCPs in the management of ILD . It also identifies areas for improvement to create a tailored telehealth model for ILD care.
Risk factors for mortality in Finnish bronchiectasis patients: A four-year study.
Mäntylä J, Mazur W, Törölä T … +2 more , Reiterä P, Kauppi P
Chron Respir Dis · 2025 · PMID 40820309 · Full text
BackgroundWe aimed to identify the risk factors associated with all-cause mortality in non-cystic fibrosis bronchiectasis (BE) patients in a Finnish cohort.MethodsIn this 4-years follow-up study, the data of non-cystic f...
BackgroundWe aimed to identify the risk factors associated with all-cause mortality in non-cystic fibrosis bronchiectasis (BE) patients in a Finnish cohort.MethodsIn this 4-years follow-up study, the data of non-cystic fibrosis adult BE patients were collected annually from medical records. Finnish translation of the disease-specific quality of life-bronchiectasis (QoL-B) questionnaire, the bronchiectasis severity index (BSI), FACED score, E-FACED score (exacerbations, (E), FEV1 (F), age (A), pulmonary bacterial colonization (C), number of lobes affected by BE (E), and dyspnoea (D), and modified Medical Research Council (mMRC) dyspnoea scale were used. Cox's regression analysis was used to evaluate factors with mortality.ResultsA total of 95 out of 205 adult non-cystic fibrosis BE patients were included and 79% of them were women with mean age of 69 years (SD ± 13). During the follow-up, eight patients died (8.4%). High scores of FACED (HR 1.9 CI 1.1-3.0), E-FACED (HR 1.5 CI 1.1-2.1) and mMRC (HR 3.2 CI 1.5-6.9) were increased the risk of mortality. The specific aetiology of BE, however, does not affect mortality. Low score of domains in QoL-B, physical ( < 0.01), vitality ( = 0.01), respiration ( = 0.03) and health ( < 0.01), were associated with mortality.ConclusionMultifactorial FACED and BSI scores increased the risk of mortality. In addition, mMRC which is a single patient reported variable was predictive for mortality. The simple mMRC scale could provide a valuable tool for clinical use.
Acceptability of a digital pulmonary rehabilitation app as an adjunct or alternative to usual care for people with chronic lung diseases: A qualitative study of patients' views and experiences.
Knight-Davidson P, Meshe OF, Jenkins TO … +8 more , Edwards GD, Patel S, Moore C, Hayden K, Ball G, Ingram KA, Nolan CM, Man WDC
Chron Respir Dis · 2025 · PMID 40803315 · Full text
BackgroundCentre-PR may not be accessible for people living distant from PR centres. Remote digital PR may have equivalent benefits to centre-PR; however, previous trials were potentially biased towards digitally literat...
BackgroundCentre-PR may not be accessible for people living distant from PR centres. Remote digital PR may have equivalent benefits to centre-PR; however, previous trials were potentially biased towards digitally literate patients, and largely excluded participants with a preference for centre-PR. There is limited data on the real-world implementation of, and acceptability for, Digital-PR alone or as an adjunct to other models of PR.ObjectivesTo gather patients' views about the acceptability of Active+me REMOTE, a digital pulmonary rehabilitation app (Digital-PR).MethodsA qualitative exploratory study using semi-structured interviews with a subset (n = 15) of patients in a mixed method, feasibility study of a hybrid pulmonary rehabilitation, blending Digital-PR with other models of PR. Transcribed data were coded descriptively using Braun and Clarkes' methodology, data interpretation was facilitated through a Miro virtual whiteboard.ResultsThere was appreciation for the concept of Digital-PR, indicated by positive responses in the domains of "friends and family recommendation," "intention to continue using the app," and "privacy concerns." Benefits were reported by two participants who had declined centre-based PR. The app was rated low regarding user-friendliness. Challenges in understanding/using the app and a perception of challenges for others were reported and were associated with poor digital literacy and tech savviness. High digital skills did not predict a favourable assessment of the app as user-friendly.DiscussionWhilst there was a general appreciation for the concept of digital PR as an adjunct or alternative to traditional centre-based PR, the app did not appear to be user-friendly, nor acceptable to people with low digital literacy. The findings have implications for the wider routine implementation of Digital-PR.
The evolving landscape of digital inhaler platforms and adherence support in chronic airways disease.
Aung HWW, Murphy A, Greening NJ
Chron Respir Dis · 2025 · PMID 40779701 · Full text
Inhaled therapies remain the cornerstone in managing chronic airway diseases, offering direct treatment delivery to the lungs with minimal systemic adverse effects. With advancements in respiratory care, digital inhalers...
Inhaled therapies remain the cornerstone in managing chronic airway diseases, offering direct treatment delivery to the lungs with minimal systemic adverse effects. With advancements in respiratory care, digital inhalers have emerged as a transformative innovation. Their functions extend beyond delivering inhaled medication, providing deeper insights into patients' medication use behaviour and intervening through complementary platform features and integrated data analytics. However, despite being available for over two decades, the widespread adoption of digital inhaler platforms remains limited due to uncertainties regarding their cost-effectiveness, feasibility in real-world settings, and concerns regarding sustainability. Identifying patient groups that could benefit most from these technologies and designing strategies for effective deployment across diverse healthcare contexts is important. To achieve this, bridging the gap between innovation and accessibility is required so that digital inhaler platforms evolve into inclusive, patient-centred tools rather than niche technologies. This narrative review provides a summary of the evolution and current landscape of digital inhaler technology, its impact on clinical outcomes in chronic airway disease, and key challenges that stakeholders should address for the successful integration of these tools into respiratory care. We also propose key components of a patient-centred digital inhaler adherence support model that prioritises accessibility and efficacy.
Longer daily oxygen use associates with more adverse events, symptoms, and worse health status in long-term oxygen therapy.
Björklund F, Ekström M
Chron Respir Dis · 2025 · PMID 40778820 · Full text
IntroductionUse of long-term oxygen therapy (LTOT) for more than 15 h per day does not reduce mortality or hospitalizations, but may increase the risk of adverse events. We evaluated the relationship between daily oxygen...
IntroductionUse of long-term oxygen therapy (LTOT) for more than 15 h per day does not reduce mortality or hospitalizations, but may increase the risk of adverse events. We evaluated the relationship between daily oxygen use duration and adverse events, symptoms, and health status in patients on LTOT.MethodsThis was a cross-sectional survey study of a random sample ( = 650) of adults with ongoing LTOT in Sweden. Oxygen use (h/day) was reported, and associations were analyzed with adverse events, symptom severities (revised Edmonton Symptom Assessment System), sleep duration and quality, and health status (COPD assessment test [CAT]).ResultsIn total, surveys from 204 patients were analyzed; 60% female, mean age 75.3 (SD 8.7) years. Swedevox baseline characteristics were similar between sampled respondents and non-respondents. Patients reporting 24 h of daily oxygen use (53.4%) also reported a higher number of total adverse events, higher ratings of dyspnea, depression and anxiety, and worse health status, compared to those reporting fewer hours of oxygen use. A longer daily duration of oxygen use also associated with a higher number of experienced adverse events, higher ratings of dyspnea and anxiety, and worse rated health status in crude and adjusted linear regression models. No associations were seen between oxygen use duration and sleep quality or duration.ConclusionMore adverse events, a higher severity of some symptoms, and worse health status are seen among patients with a longer daily duration of oxygen use. Further research is needed to establish evidence of causality.
What are the important components of physical activity for people with fibrotic interstitial lung disease?
Hoffman M, Mellerick CR, Burge AT … +1 more , Holland AE
Chron Respir Dis · 2025 · PMID 40763803 · Full text
IntroductionFibrotic interstitial lung disease (fILD) is characterized by scarring of the lungs, decline in lung function and compromised exercise capacity. People with fILD participate in less daily physical activity co...
IntroductionFibrotic interstitial lung disease (fILD) is characterized by scarring of the lungs, decline in lung function and compromised exercise capacity. People with fILD participate in less daily physical activity compared to healthy controls, however, the relative importance of physical activity components (volume, intensity, duration) is unknown. This study aimed to examine the relationship between the components of physical activity and established disease severity and impact measures in fILD.MethodsParticipant data were from baseline assessment of a randomized controlled trial recruiting people with fILD and exertional desaturation during exercise testing on room air. Physical activity components including volume (steps per day), intensity (light, moderate and vigorous) and duration (time spent in different physical activity intensities) were objectively assessed for 7 days using two physical activity monitors. Associations of these components with lung function (FVC, FEV, TLCO), functional exercise capacity (6-min walk distance, 6MWD) and dyspnea (Dyspnea-12 questionnaire) were investigated.Results106 participants with mild to severe fILD were included. Physical activity volume was not associated with 6MWD (r = 0.027, = 0.78) and weakly associated with lung function (FVC r = 0.33, = 0.001; FEV r = 0.34, = 0.001). Physical activity intensity and duration were weakly associated with 6MWD (light r = 0.22 = 0.02; moderate r = 0.42, < 0.001; vigorous r = 0.33, = 0.01). Time spent in vigorous physical activity was weakly associated with lung function (FVC r = 0.19, = 0.05; FEV r = 0.18, = 0.006). Dyspnea scores were not associated with any physical activity variables. Relationships remained consistent after adjusting for age, gender and disease severity, with the exception of vigorous physical activity which was no longer associated with lung function or 6MWD.ConclusionIn people with fILD, the physical activity components of volume, intensity and duration were associated with different measures of disease severity and impact. This highlights the importance of considering specific physical activity components when evaluating and promoting physical activity in this group.
Diagnostic value of Peptest™ combined with gastroesophageal reflux disease questionnaire in identifying patients with gastroesophageal reflux-induced chronic cough.
Yuan J, Luo X, Huang L … +6 more , Zhou Y, Sha B, Zhang T, Wang S, Yu L, Xu X
Chron Respir Dis · 2025 · PMID 40749725 · Full text
ObjectivesGastroesophageal reflux-related chronic cough (GERC), an extraesophageal manifestation of gastroesophageal reflux disease (GERD). Although 24h MII-pH monitoring is the gold standard for diagnosing GERC, its inv...
ObjectivesGastroesophageal reflux-related chronic cough (GERC), an extraesophageal manifestation of gastroesophageal reflux disease (GERD). Although 24h MII-pH monitoring is the gold standard for diagnosing GERC, its invasiveness, high cost, and limited accessibility hinder widespread use in many clinical settings. This study aimed to develop a non-invasive machine learning model incorporating Peptest™ and GerdQ scores to facilitate GERC detection, particularly in primary care and resource-limited environments where MII-pH testing is not readily available.Methods210 chronic cough patients were enrolled between September 2022 and June 2024. GERC diagnosis followed established guidelines, and salivary pepsin levels were measured via Peptest™. Feature selection was performed using the Boruta algorithm (hereafter referred to as Boruta), a method based on random forest (RF), designed to identify relevant variables by comparing them to random shadow features. The selected optimal features were then evaluated using nine ML models, including logistic regression (LR), RF and others. Model performance was assessed through area under the curve (AUC), decision curve analysis (DCA), and calibration curves.Results73 (34.76%) patients had GERC. Peptest™ and GerdQ scores were key predictors. Logistic regression was selected for its balance of accuracy (AUC: 0.876) and clinical utility. The nomogram model showed excellent discrimination and calibration. DCA indicated high net benefit at prediction thresholds of 0.10-0.90. RCS analysis revealed non-linear relationships: GERC risk increased with GerdQ >8.66 and Peptest™ >54.791 ng/ml.ConclusionThe nomogram model provides a reliable, non-invasive tool for GERC diagnosis, aiding timely clinical intervention, especially for patients unsuitable for pH testing.
Functional status in COPD: Comparison with healthy controls and impact of an exacerbation.
Hermans F, Arents E, Blondeel A … +5 more , Cardinaels N, Janssens W, Troosters T, Derom E, Demeyer H
Chron Respir Dis · 2025 · PMID 40626413 · Full text
BackgroundFunctional status is a marker for evaluating fall risk and predicting mortality and hospitalisations in elderly and patients with COPD. Acute exacerbations of COPD result in sudden declines in exercise capacity...
BackgroundFunctional status is a marker for evaluating fall risk and predicting mortality and hospitalisations in elderly and patients with COPD. Acute exacerbations of COPD result in sudden declines in exercise capacity, quadriceps force (QF) and physical activity (PA), but their impact on functional status remains unclear. This study aimed to (i) compare the functional status of patients with COPD to healthy controls and (ii) assess prospectively the impact of an exacerbation on functional status.MethodsHealthy controls and patients were assessed. Patients were followed up every 6 months and were tested again immediately if they reported an exacerbation. The short physical performance battery (SPPB), timed up and go test (TUG), 1-minute sit-to-stand test (1MSTS), 6-minute walking distance (6MWD), QF and PA (accelerometery) were measured.ResultsThirty-six patients (69 ± 7 years, 69% male) and 25 matched healthy controls (68 ± 7 years, 80% male) were included. Functional status was decreased in patients compared to healthy controls. Twelve patients were retested 10 ± 7 days after a moderate (n = 11) or severe (n = 1) exacerbation. The 1MSTS (∆-3 ± 3repetitions, p < 0.0001), 6MWD (∆-34 ± 46m, p < 0.0001) and QF (∆-9 ± 13Nm, p = 0.05) decreased after exacerbation onset. No changes in SPPB and PA were observed.ConclusionAn exacerbation negatively impacts the already reduced functional status in patients with COPD. The SPPB is not able to capture this decline.
Clinical and socioeconomic parameters as predictors for longer hospital stay and mortality in COPD.
Shlomi D, Benderly M, Olmer L … +1 more , Kalter-Leibovici O
Chron Respir Dis · 2025 · PMID 40583049 · Full text
BackgroundIdentifying clinical and socio-economic predictors of adverse health outcomes in chronic obstructive pulmonary disease (COPD) patients is imperative for reducing exacerbation and mortality rates.MethodsThe COPD...
BackgroundIdentifying clinical and socio-economic predictors of adverse health outcomes in chronic obstructive pulmonary disease (COPD) patients is imperative for reducing exacerbation and mortality rates.MethodsThe COPD Community Disease Management (COPD-CDM) clinical trial evaluated the efficacy of a disease management program among 1202 ambulatory COPD patients receiving recommended care. The study did not find disease management to be superior to recommended care only, in preventing COPD hospital admissions or mortality. This post-hoc analysis examined the association of clinical and socioeconomic parameters with the length of in-hospital stay and all-cause mortality by multivariable non-linear mixed and Cox proportional hazards models, adjusted for age, sex, study arm, recruitment and study period, and medical therapy.ResultsA one-point increment in the Modified Medical Research Council dyspnea scale was associated with a higher hazard for all-cause mortality, (Hazards Ratio [HR]:1.50, 95% confidence interval [CI]: 1.22-1.85); longer in-hospital stay for COPD or all causes; Rate Ratio (95% CI): 1.64 (1.36-1.98), and 1.36 ( 1.19-1.55), respectively. A 50 m increment in six-minute walking distance was associated with fewer days in-hospital for both COPD and all causes; Rate Ratio (95% CI); 0.94 (0.89-0.99) and 0.95 (0.92-0.99), respectively. Unemployment and lower educational attainment were associated with a longer in-hospital stay both for COPD and all causes.ConclusionsClinical and socioeconomic parameters were associated with the number of days in hospital for COPD and all-causes, and all-cause mortality in ambulatory COPD patients. Our findings support the importance of a multi-disciplinary pulmonary approach to improve clinical outcomes among COPD patients.
Effect of individual nutritional therapy during inpatient pulmonary rehabilitation in patients at risk for malnutrition and sarcopenia - a randomized controlled trial.
Coiro M, Zurfluh A, Lehmann U … +6 more , Brun P, Scheel-Sailer A, Tschanz H, van Hoof A, Wilhelm M, Marcin T
Chron Respir Dis · 2025 · PMID 40518743 · Full text
BackgroundMalnutrition and sarcopenia are common in inpatient rehabilitation, however individual nutritional therapy (iNT) is often underutilized. This study aimed to assess the effect of iNT on nutrition and muscular he...
BackgroundMalnutrition and sarcopenia are common in inpatient rehabilitation, however individual nutritional therapy (iNT) is often underutilized. This study aimed to assess the effect of iNT on nutrition and muscular health.MethodPatients with chronic obstructive pulmonary disease (COPD) or post-pneumonia at risk for malnutrition and sarcopenia undergoing inpatient rehabilitation were enrolled. The control group received usual care including enriched food and educational group sessions on nutrition. The intervention group received additional counselling by a dietician twice a week. Both groups received individualized physiotherapy and self-management coaching, endurance exercise sessions on 5 days and strength training sessions on 2-3 days per week as part of the clinical routine. Primary outcomes were changes in energy and protein intake, assessed via menu consumption and macronutrient analysis. Secondary outcomes included handgrip strength, muscle mass by bioimpedance analysis, and physical performance measured by the timed-up-and-go test.ResultsTwenty-six patients per group (median age of 72 years, 60% men, 52% COPD) were included. Energy and protein intake increased significantly more in the intervention group with a 309 kcal and 16 g compared to -53 kcal and -1 g in the control group ( = 0.001 for group differences). Handgrip improved more in the intervention group by a median of 1 kg ( = 0.007), without group differences in muscle mass or physical performance.ConclusionINT effectively increased energy and protein intake in patients at risk of malnutrition and sarcopenia undergoing 3 weeks of pulmonary rehabilitation, with a positive impact on prognostic handgrip strength.Trial registrationThe study was registered by the US National Institutes of Health (ClinicalTrials.gov). # NCT05096013.
Comparative analysis of pulmonary function decline in patients undergoing bronchoscopic lung volume reduction with endobronchial valves versus conservative treatment in emphysema management: A longitudinal coarsened exact matched analysis.
Wienker J, Darwiche K, Karpf-Wissel R … +10 more , Westhölter D, Büscher E, Zensen S, Haubold J, Kersting D, Hautzel H, Homola J, Taube C, Opitz M, Struß M
Chron Respir Dis · 2025 · PMID 40498987 · Full text
BackgroundChronic obstructive pulmonary disease (COPD) and emphysema display a chronic and progressive disease for the individual patient. The forced expiratory volume in one second (FEV) is declining with age as display...
BackgroundChronic obstructive pulmonary disease (COPD) and emphysema display a chronic and progressive disease for the individual patient. The forced expiratory volume in one second (FEV) is declining with age as displayed in the Fletcher-Peto curve. Despite established benefits of bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBVs), long-term data suggest a gradual reduction in the magnitude of these benefits.PurposeThis study aimed to compare the rate of lung function change in emphysema patients undergoing BLVR versus those receiving conservative management, utilizing coarsened exact matching to ensure balanced baseline characteristics.Patients and MethodsIn this retrospective single center study data between 2015 and 2021 was analyzed. BLVR patients achieving significant volume reduction (≥563 mL) were matched to conservatively managed controls based on age, sex, BMI, and smoking history. Pulmonary function changes after successful BLVR with valves, including forced expiratory volume in one second (FEV) and residual volume (RV), were monitored and analyzed over a 3-year period.ResultsA total of 60 patients, evenly distributed between the two groups (30 each), were included in the analysis. Median FEV change was -0.063 L/year for BLVR patients and -0.066 L/year for controls. No statistically significant differences in annual FEV and RV changes were observed (-0.07 vs -0.08, = 0.492; -0.07 vs -0.07, = 0.569; -0.05 vs -0.04, = 0.636 at follow-ups in years 1, 2, and 3, respectively for FEV and +0.20 vs +0.25, = 0.643; +0.80 vs +0.65, = 0.960; +1.0 vs +0.85, = 0.963 at follow-ups in years 1, 2, and 3, respectively for RV).ConclusionIn this matched cohort analysis, no significant differences in annual changes in FEV or RV progression were observed between patients after successful BLVR with valves and patients under conservative treatment. The results indicate that COPD progression is the main factor for the decline in functional improvement after successful BLVR with valves.
Differences in COPD management across clinician type: Maintenance treatment habits and patient characteristics among US pulmonologists, internal/family medicine physicians, nurse practitioners, and physician assistants.
Castro M, Carney KC, Romanelli SM … +4 more , Dixon AL, Abdul Rahman MQ, Aggarwal K, Yawn BP
Chron Respir Dis · 2025 · PMID 40474433 · Full text
ObjectivesTreatment recommendations for chronic obstructive pulmonary disease (COPD) are based on single or combination long-acting bronchodilator therapy (β-agonists [LABAs] or muscarinic receptor antagonists [LAMAs]),...
ObjectivesTreatment recommendations for chronic obstructive pulmonary disease (COPD) are based on single or combination long-acting bronchodilator therapy (β-agonists [LABAs] or muscarinic receptor antagonists [LAMAs]), with inhaled corticosteroids (ICS) for those at risk of exacerbations. This study evaluated differences in patient characteristics and treatment patterns among US clinicians.MethodsMedical record data for patients with COPD were abstracted via a retrospective cross-sectional survey by pulmonologists, internal/family medicine physicians, nurse practitioners (NPs) and physician assistants (PAs).ResultsData on 700 patients were collected from 175 clinicians: 100 pulmonologists, 45 internal/family medicine physicians, 30 NP/PAs. Respondents classified patients as having Mild (11%), Moderate (51%), or Severe/Very Severe (38%) COPD, with highest perceived disease burden for patients with Severe/Very Severe COPD. Dual therapies were prescribed differently according to clinician type. Internal/family medicine physicians and NP/PAs prescribed LABA/ICS to a significantly higher proportion of patients than pulmonologists, who favored use of dual bronchodilator therapy. Regardless of clinician type, COPD management was complex, with patients starting and transitioning to multiple treatments throughout their care.ConclusionDifferences in COPD treatment patterns exist across US clinicians. Despite current maintenance treatment, COPD had a profound impact on patients, indicating a need for improved therapies for COPD.
Cut-offs for daily step counts are associated with measures of health status in people with COPD: An observational study.
Dos Santos JMB, de Lima FF, Censo CM … +5 more , Santos EA, Ito JT, Xavier RF, Carvalho-Pinto RM, Carvalho CRF
Chron Respir Dis · 2025 · PMID 40421597 · Full text
To explore the associations between preestablished daily step count cut-offs and health status, dyspnoea, and psychosocial distress in individuals with COPD. A cross-sectional analysis was performed on 252 individuals w...
To explore the associations between preestablished daily step count cut-offs and health status, dyspnoea, and psychosocial distress in individuals with COPD. A cross-sectional analysis was performed on 252 individuals with COPD. PADL was objectively assessed using a triaxial accelerometer, and participants were categorized as physically active or inactive according to three daily step count cut-offs previously reported for individuals with COPD (4,300, 4,580, and 5000 steps/day). Health status was measured via the COPD Assessment Test (CAT) and Clinical COPD Questionnaire (CCQ), dyspnoea was assessed via the modified Medical Research Council (mMRC) scale, and psychosocial distress was evaluated via the Hospital Anxiety and Depression Scale (HADS). Meeting the cut-off of 5000 steps/day was associated with lower CAT scores and depressive symptoms. Meeting the cut-off of 4300 steps/day was associated with less dyspnoea (mMRC < 2). No significant associations were observed between anxiety symptoms and step count cut-offs. The 4580 steps/day cut-off did not predict health outcomes. A daily step count of 5000 steps appears to be the most effective threshold for distinguishing between different levels of health status and depressive symptoms in individuals with COPD. These findings suggest that step counts can be used as a clinical health indicator in this population. Future interventional studies are needed to confirm our findings.
The prevalence of metabolic syndrome in chronic obstructive pulmonary disease: A systematic review and meta-analysis.
Alrabbaie H, Al-Wardat M, Etoom M … +3 more , Beauchamp M, Goldstein R, Brooks D
Chron Respir Dis · 2025 · PMID 40415696 · Full text
ObjectiveMetabolic syndrome (MetS) is a cluster of factors that increase the risk of cardiovascular disease and type 2 diabetes. It is highly prevalent among patients with Chronic Obstructive Pulmonary Disease (COPD). Th...
ObjectiveMetabolic syndrome (MetS) is a cluster of factors that increase the risk of cardiovascular disease and type 2 diabetes. It is highly prevalent among patients with Chronic Obstructive Pulmonary Disease (COPD). This systematic review and meta-analysis assessed MetS prevalence in COPD patients, focusing on variations by gender, diagnostic criteria, and disease severity.MethodsWe systematically searched MEDLINE, Embase, Scopus, and CINAHL. Two reviewers independently extracted data using a standardized form, and study quality was assessed with the Joanna Briggs Institute checklist. Prevalence rates, with 95% confidence intervals (CI), were calculated using a random-effects model. Subgroup analyses by sex, COPD severity, and MetS components were conducted.ResultsForty-two studies, including 54,278 COPD patients, were analyzed. Overall, the prevalence of MetS was 37% (95% CI: 30.6-43.8%; I = 99.03%, p < 0.001). Prevalence was 48% (95% CI 38.1 to 57.5) in males and 43% (95% CI 38.3 to 48.8) in females. Among studies using the Alberti definition, the pooled prevalence was 46% (95% CI 35.6 to 56.3). Patients with GOLD stage II showed a prevalence of 44% (95% CI 37.3 to 50.4). The most common MetS components were Hypertension 58% (95% CI 47.2 to 68.0) and increased waist circumference 51% (95% CI 37.1 to 64.6).ConclusionMetS is highly prevalent among COPD patients. Standardized diagnostic criteria are needed, and early detection with integrated care is recommended.
Correlations between exercise oxygen consumption, lung function, image findings, and quality of life in adults with post-tuberculosis lung disease.
da Silva MPVL, da Silva Pinto PVL, Fonseca IMPP … +5 more , de Lima LS, Carneiro AS, Costa W, Santos AP, Lopes AJ
Chron Respir Dis · 2025 · PMID 40404177 · Full text
The aim of this study is to evaluate the correlations of peak oxygen uptake (VO2peak) with lung mechanics, radiographic abnormalities, and quality of life (QoL) in adults with post-tuberculosis lung disease (PTLD). This...
The aim of this study is to evaluate the correlations of peak oxygen uptake (VO2peak) with lung mechanics, radiographic abnormalities, and quality of life (QoL) in adults with post-tuberculosis lung disease (PTLD). This is a cross-sectional study in which 60 adults with PTLD underwent a cardiopulmonary exercise test (CPET). Additionally, the following assessments were performed: spirometry, impulse oscillometry (IOS), chest X-ray (CXR), and QoL using the WHOQOL-BREF. The mean peak oxygen uptake (VO) was 16.1 ± 6.8 ml/kg/min. There were positive correlations between VO and several parameters, including height, physical-WHOQOL-BREF, and forced vital capacity (FVC). There were negative correlations between VO and several parameters, including age, heterogeneity of resistance between 5 and 20 Hz, frequency response (Fres), and reactance-area. In IOS, patients with small airway disease (SAD) had a lower VO. Regarding CXR, only cavitation and nodular opacities were associated with a lower VO. In multivariate analysis, FVC, age, male sex, and Fres explained 65.2% of the variability in VO. In conclusion, there is a relationship between VO and lung mechanics in patients with PTLD. In these patients, IOS is able to detect more pulmonary mechanical alterations than spirometry, including those reflecting SAD. Thus, the use of both CPET and IOS may aid in the monitoring of patients with PTLD.
Real-time experience of an acute exacerbation of COPD: A qualitative exploration.
Alkhathlan BS, Barradell AC, Greening NJ … +2 more , Harvey-Dunstan T, Singh SJ
Chron Respir Dis · 2025 · PMID 40359900 · Full text
Many qualitative studies have explored patients' experiences of an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) retrospectively. To our knowledge, no study has conducted a real-time investigation...
Many qualitative studies have explored patients' experiences of an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) retrospectively. To our knowledge, no study has conducted a real-time investigation of COPD exacerbation experience during hospitalisation. To establish an in-depth and comprehensive understanding of the whole COPD exacerbation experience and uncover any unrecognised burdens that might serve as barriers to engagement in discharge services post-AECOPD. Semi-structured interviews were conducted, and data were analysed using thematic analysis. The study included participants who were admitted to the hospital with a primary diagnosis of AECOPD. Twelve participants were included in the study (Male, = 9; Female, = 3), with a mean ± SD age of 66 ± 8 years. Findings generated three overarching themes, and sub-themes: (I) Health deterioration phase (II) Implications of AECOPD and the associated hospitalisation, and (III) Recovery journey. The impact of breathlessness appears to extend across the COPD exacerbation journey and, for some, well beyond. Breathlessness both within and extending beyond the acute phase was associated with comorbid psychological distress. Interventions should consider appropriate phasing within the management process, focus on breathlessness and involve a behavioural therapy component.
Staging of obesity-associated hypoventilation in patients with morbid obesity scheduled for bariatric surgery.
Kania A, Tęczar J, Celejewska-Wójcik N … +2 more , Major P, Polok K
Chron Respir Dis · 2025 · PMID 40279707 · Full text
Almost 20% of Polish citizens aged >15 years are obese and this number is increasing. Numerous obesity-associated diseases include, quite notably, also sleep-related breathing disorders and hypoventilation. This study ai...
Almost 20% of Polish citizens aged >15 years are obese and this number is increasing. Numerous obesity-associated diseases include, quite notably, also sleep-related breathing disorders and hypoventilation. This study aimed to analyse the prevalence of obesity hypoventilation syndrome (OHS) and hypoventilation staging in a group of patients qualified for bariatric surgery within the Comprehensive Specialist Care in Bariatrics (KOS-BAR) pilot program designed and running in Poland since 2021. Prior to the bariatric procedure, the participants were referred to a pulmonologist for assessment. We retrospectively analysed the records of 134 patients. Almost all of the tested bariatric patients ( = 122, 91.0%) had obstructive sleep apnea mainly classified as severe (59.0%). Hypoventilation was confirmed in 30 patients (22.4%), and in 37.9% of them, increased levels of serum bicarbonate were found. Chronic diurnal hypercapnia was confirmed in 7.9% of patients (10/122). Hypoventilation as well as obstructive sleep apnea in the obese population is a significant issue. The presented study group included patients in stages 0-IV of obesity-associated hypoventilation. The conducted analysis suggests that the most common form of hypoventilation among patients qualified for bariatric surgery is obesity-associated sleep hypoventilation (stage I).
Relationship among depressive symptoms, dyspnea-related fear and sarcopenia in patients with chronic obstructive pulmonary disease: The mediating effect of physical activity.
Wang W, Wang L, Fan R … +2 more , Xie L, Zhu J
Chron Respir Dis · 2025 · PMID 40245314 · Full text
Sarcopenia is influenced by multiple factors, including psychological aspects. This study aimed to explore the relationships among depressive symptoms, dyspnea-related fear, and sarcopenia, with a focus on the mediating...
Sarcopenia is influenced by multiple factors, including psychological aspects. This study aimed to explore the relationships among depressive symptoms, dyspnea-related fear, and sarcopenia, with a focus on the mediating role of physical activity. A cross-sectional study was conducted among 348 COPD patients at a tertiary hospital in Western China from July 2023 to July 2024. Sarcopenia was assessed according to the 2019 AWGS criteria, including hand bioelectrical impedance analysis (BIA), and grip strength testing. Depressive symptoms, dyspnea-related fear, and physical activity were evaluated through self-reported measures using the depression subscale of the Hospital Anxiety and Depression Scale (HADS), the Breathlessness Beliefs Questionnaire (BBQ), and the International Physical Activity Questionnaire Short Form (IPAQ-SF), respectively. Logistic regressions analyses explored associations among depressive symptoms, dyspnea-related fear, and sarcopenia. Maximum Likelihood (ML) estimation was employed using Mplus software to evaluate the mediating effect of physical activity on the relationships. The prevalence of sarcopenia among COPD patients was 60.3%. In the logistic regression analysis with sarcopenia as the dependent variable, physical activity levels (OR = 0.508, = 0.019) and depressive symptoms (OR = 1.079, = 0.029) were statistically significant, while BBQ scores were not (OR = 1.031, = 0.070). Mediating analyses revealed that depressive symptoms directly increased the risk of sarcopenia (β = 0.076, = 0.042) but did not do so indirectly via physical activity (β = 0.056, = 0.146). Conversely, dyspnea-related fear had an indirect effect on sarcopenia through physical activity, with a borderline statistical significance (β = 0.053, = 0.049). This study highlights the critical role of psychological factors in sarcopenia development among COPD patients, with physical activity serving as a significant mediator. These findings underscore the need for integrated rehabilitation strategies addressing both psychological and physical activity barriers to improve outcomes for COPD patients.
IgG antibody testing in the diagnosis of hypersensitivity pneumonitis: A scoping review.
Hatim L, Denning DW
Chron Respir Dis · 2025 · PMID 40237653 · Full text
BackgroundDiagnosis of hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis requires a combination of tests with antibody testing playing a supportive role to identify exposures.ObjectivesWe conducted a sco...
BackgroundDiagnosis of hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis requires a combination of tests with antibody testing playing a supportive role to identify exposures.ObjectivesWe conducted a scoping review on antibody testing in -related HP to identify the utility and diagnostic cutoffs proposed in the literature. We compared these cutoffs with studies of chronic pulmonary aspergillosis (CPA) and manufacturers' cutoffs.Eligibility criteriaOnly studies addressing the diagnostic value of IgG or precipitins for HP were included. Separately papers defining cutoffs for CPA were tabulated.Sources of evidencePublished papers were identified in literature searches in Embase, Web of Science, and Medline.ResultsWe identified 414 papers, of which 12 were included, all published between 1965 and 2005. Occupational HP linked to spp. exposure included Farmer's Lung, Malt-Worker's Lung, Esparto Worker's Lung, and Woodworker's lung (Sawmill-workers). No studies directly addressed serological testing in Tobacco Worker's lung, Compost Lung, or poultry workers. Among species exposure, was most commonly described; others included (now ), , and . Antibody tests included ELISA, BALISA, precipitin tests and ImmunoCAP, with a higher sensitivity of ELISA and ImmunoCAP tests compared to precipitin tests. Patients with HP linked to exposures, were positive in 156/290 (53.8%) compared to 96/615 (15.6%) in those with similar occupational exposures without HP. In malt workers with HP 35/53 (66%) had detectable IgG antibody compared to 0/53 IgG, and 13/74 (18%) exposed but unaffected workers, but are not commercially available.ConclusionsImproved means of establishing or ruling out exposure are required, given the negative consequences for patients of continued inhalation. Modern studies with commercially available IgG antibody assays are required to define appropriate cutoffs for HP, given numerous studies published for chronic pulmonary aspergillosis.
Clinical characteristics and prognosis prediction in patients with AECOPD and type 2 diabetes mellitus: A multicenter observational study.
Li X, Yi Q, Luo Y … +16 more , Wei H, Ge H, Liu H, Zhang J, Li X, Xie X, Pan P, Yi M, Cheng L, Zhou H, Liu L, Zhou C, Zhang J, Peng L, Pu J, Zhou H
Chron Respir Dis · 2025 · PMID 40114423 · Full text
ObjectivesDiabetes is a common comorbidity in COPD population. This study aimed to explore the impacts of T2DM on clinical characteristics and outcomes of patients with exacerbation of COPD, as well as develop a specifie...
ObjectivesDiabetes is a common comorbidity in COPD population. This study aimed to explore the impacts of T2DM on clinical characteristics and outcomes of patients with exacerbation of COPD, as well as develop a specified prognostic model for these patients.MethodsAECOPD patients were enrolled from a prospective, noninterventional, multicenter cohort study. Propensity score matching with a 1:2 ratio was performed to compare the characteristics and prognosis between patients with and without T2DM. Predictors for short-term mortality were determined by logistic regression analysis and a prediction nomogram were established and further validated in another cohort.ResultsA total of 1804 AECOPD patients with T2DM and 3608 matched patients without T2DM were included. AECOPD patients with T2DM presented with worse disease profile and prognosis. Eight independent predictors for short-term mortality were determined, including advanced age, disturbance of consciousness, chronic cardiac disease, low blood pressure, high heart rate, elevated neutrophil, urea nitrogen and random blood glucose. A prognostic nomogram was established with an AUC of 0.878 (95%CI: 0.842-0.915) in derivation cohort and 0.834 (95% CI: 0.767-0.901) in validation cohort, which was superior to DECAF (0.647 [95%CI: 0.535-0.760]) and BAP-65 score (0.758 [95%CI: 0.666-0.850]). The calibration curve and decision curve analysis also indicated its accuracy and applicability. Besides, a web calculator based on the nomogram was constructed to simplify the use of prognostic nomogram in clinical practice.ConclusionsComorbid diabetes is significantly associated with severe disease profile and worse prognosis in AECOPD population. Our nomogram may help to facilitate early risk assessment and proper decision-making among patients with AECOPD and T2DM.
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