Chron Respir Dis [JOURNAL]
Sun
200 papers
Effect of a nurse-led integrated care intervention on quality of life and rehospitalisation in patients with severe exacerbation of COPD-a pilot study.
Schmid-Mohler G, Hübsch C, Braun J … +4 more , Steurer-Stey C, Aregger C, Schaer DJ, Clarenbach C
Chron Respir Dis · 2024 · PMID 39407408 · Full text
OBJECTIVE: To explore the feasibility and effect of a nurse-led integrated care intervention on health-related quality of life (QoL) and unplanned 90-day rehospitalisation in patients hospitalised due to acute exacerbati...
OBJECTIVE: To explore the feasibility and effect of a nurse-led integrated care intervention on health-related quality of life (QoL) and unplanned 90-day rehospitalisation in patients hospitalised due to acute exacerbation of COPD (AECOPD). METHOD: A monocentric non-randomized parallel cluster design was applied. The primary endpoint was the difference between Chronic Respiratory Questionnaire (CRQ) Mastery Scores at hospital discharge and 13 weeks post-discharge. Secondary endpoints were differences between other CRQ scores, numbers of rehospitalisations and self-reported exacerbations. The study would end either 13 weeks after the full sample size was achieved or when study time ran out. RESULTS: The study was terminated before reaching the targeted sample size. Of 174 invitees, 69 (39.7%, 30 control, 39 intervention) consented to participate. Of those, 47 completed the study, 45 of whom had complete data sets for the primary endpoint. No differences in QoL scores, unplanned COPD-related rehospitalisations or unplanned all-cause rehospitalisations were detected. The mean number of self-reported moderate exacerbations was higher in the intervention group ( = 0.006). CONCLUSION: The pilot study had slow recruitment, high drop-out rates, and no significant effect on 3-month outcomes. Further research should focus on enhancing the current understanding of how to motivate and recruit patients in this setting. CLINICALTRIALS.GOV ID: NCT04011332.
The one-minute sit-to-stand test: A practical tool for assessing functional exercise capacity in patients with COPD in routine clinical practice.
Mellaerts P, Demeyer H, Blondeel A … +12 more , Vanhoutte T, Breuls S, Wuyts M, Coosemans I, Claes L, Vandenbergh N, Beckers K, Bossche LV, Stylemans D, Janssens W, Everaerts S, Troosters T
Chron Respir Dis · 2024 · PMID 39400070 · Full text
Chronic obstructive pulmonary disease (COPD) is associated with a reduced exercise capacity. Although several field tests for exercise capacity have been modified for non-standard settings, i.e. outside the hospital clin...
Chronic obstructive pulmonary disease (COPD) is associated with a reduced exercise capacity. Although several field tests for exercise capacity have been modified for non-standard settings, i.e. outside the hospital clinic or pulmonary rehabilitation center, their uptake remains limited. To assess the test-retest reliability, constuct validity and responsiveness of the one-minute sit-to-stand test (1'STST) adopted in clinical practice among patients with COPD and to confirm the earlier established minimal important difference (MID) of three repetitions. Patients with COPD performed two 1'STSTs, two 6-minute walk tests (6MWT), an isometric quadriceps force (QF) measurement, a cardiopulmonary exercise test (CPET), and a seven-day physical activity (PA) measurement before and after three months of pulmonary rehabilitation (PR). An Intraclass Correlation Coefficient (ICC) evaluated the agreement between two 1'STSTs. Pearson Correlation examined the association between the 1'STST and other physical measurements, and their changes following PR. A receiver operating characteristic (ROC) curve was constructed using a 30-meter increment in the 6MWT as cut-off to identify responders. The 1'STST demonstrated good reliability (Δ0.9 ± 4.0 repetitions, = .13; ICC = 0.79). The 1'STST was moderately correlated with the 6MWT (r = 0.57, < .0001), VOmax (r = 0.50, = .0006) and maximal work rate (r = 0.52, = .0003). Weak correlations were observed with QF (r = 0.33, = .03) and step count (r = 0.38, = .013). The 1'STST improved after PR (∆ = 3.6 ± 6.4 repetitions, = .0013) and changes correlated moderately with changes in the 6MWT (r = 0.57, = .002), QF (r = 0.48, = .003) and VOmax (r = 0.41, = .014). A cut-off of three repetitions demonstrated a 71% accuracy in identifying responders to a rehabilitation program. The 1'STST is a valuable alternative to evaluate exercise capacity in patients with COPD when more expensive and time-consuming tests are unavailable.
Supporting delivery of remote pulmonary rehabilitation across different healthcare contexts: A multi-national study.
Cox NS, Rawlings S, Lannin NA … +4 more , Candy S, Bhatt SP, Babu AS, Holland AE
Chron Respir Dis · 2024 · PMID 39373116 · Full text
This study aimed to understand factors that health professionals, from a variety of healthcare contexts and countries, believed support remote delivery of pulmonary rehabilitation (PR); and to develop a targeted interven...
This study aimed to understand factors that health professionals, from a variety of healthcare contexts and countries, believed support remote delivery of pulmonary rehabilitation (PR); and to develop a targeted intervention to support implementation of remote PR. A 3-phase participatory action-research process was employed, across three study hubs in three countries (NZ, India, USA), representing diverse healthcare delivery contexts. Phase 1 employed focus groups of health professionals working in PR; data were analysed qualitatively with transcripts coded against two implementation frameworks (Theoretical Domains Framework (TDF) and Consolidated Framework for Implementation Research (CFIR)). Findings informed development of an online toolbox to support delivery of remote PR (Phase 2), which was evaluated using semi-structured interviews (Phase 3). 20 health professionals participated across all study phases. Factors considered to influence implementation of remote PR were consistent across diverse healthcare contexts and related to staffing availability, skills and confidence, and equipment and technology accessibility. An online toolbox provided support for enhancing knowledge and confidence, but was not able to address all implementation barriers. Key factors to support clinicians deliver remote PR are common across different healthcare contexts, suggesting broader telerehabilitation implementation strategies may be applicable across healthcare environments.
Participant-selected music listening during pulmonary rehabilitation in people with chronic obstructive pulmonary disease: A randomised controlled trial.
Lee AL, Butler SJ, Jung P … +4 more , Clark IN, Tamplin J, Goldstein RS, Brooks D
Chron Respir Dis · 2024 · PMID 39367818 · Full text
To evaluate the impact of participant-selected music listening as an adjunct to pulmonary rehabilitation (PR) in people with COPD. Adults with COPD referred to PR were randomly assigned to participant-selected music list...
To evaluate the impact of participant-selected music listening as an adjunct to pulmonary rehabilitation (PR) in people with COPD. Adults with COPD referred to PR were randomly assigned to participant-selected music listening (intervention group, [IG]) or usual care (control group [CG]) during an 8-weeks PR program. Prior to training, the IG completed an interview with a registered music therapist to identify music preferences. IG participants listened to an individualised playlist; CG participants had usual care. Primary outcomes included end-6-min walk test symptoms (dyspnoea and exertion) and dyspnoea (Multidimensional Dyspnoea Profile [MDP]), measured pre and post PR and 6-months follow-up. 58 participants, FEV1 52.4 (25.9)% pd) were recruited. There were no between-group differences following the intervention ( > .05 for all outcomes at all time points). Within-group differences following PR were significant for MDP sensory quality: IG mean difference [95% CI] -2.2 [-3.3 to -1.2]; CG -1.5 [-2.5 to -0.5] points; MDP emotional response: IG -3.2 [-4.2 to -2.3]; CG -2.2 [-3.2 to -1.3] points). Participant-selected music listening during PR offered no greater benefit to symptoms of dyspnoea or exertion compared to usual care. With the study limited by COVID-19 restrictions, the role of this adjunct remains to be clarified.
The effects of inspiratory muscle training on biomarkers of muscle damage in recovered COVID-19 patients after weaning from mechanical ventilation.
Iqbal M, Hassan K, Bliss E … +3 more , Whiteside EJ, Hoffman B, Mills DE
Chron Respir Dis · 2024 · PMID 39365635 · Full text
COVID-19 patients experience respiratory muscle damage, leading to reduced respiratory function and functional capacity often requiring mechanical ventilation which further increases susceptibility to muscle weakness. In...
COVID-19 patients experience respiratory muscle damage, leading to reduced respiratory function and functional capacity often requiring mechanical ventilation which further increases susceptibility to muscle weakness. Inspiratory muscle training (IMT) may help mitigate this damage and improve respiratory function and functional capacity. We studied the effects of IMT on muscle damage biomarkers, respiratory function, and functional capacity in COVID-19 recovered young adults, successfully weaned from mechanical ventilation. Participants were randomly allocated to either an IMT ( = 11) or control (CON; = 11) intervention for 4 weeks. The IMT group performed 30 dynamic inspiratory efforts twice daily, at 50% of their maximal inspiratory mouth pressure (P) while the CON group performed 60 inspiratory efforts at 10% of daily. Serum was collected at baseline, week two, and week four to measure creatine kinase muscle-type (CKM), fast skeletal troponin-I (sTnI) and slow sTnI. Time × group interaction effects were observed for CKM and slow sTnI, but not for fast sTnI. Both were lower at two and 4 weeks for the IMT compared to the CON group, respectively. Time × group interaction effects were observed for forced expiratory volume in 1s, forced vital capacity, P and right- and left-hand grip strength. These were higher for the IMT compared to the CON group. Four weeks of IMT decreased muscle damage biomarkers and increased respiratory function and grip strength in recovered COVID-19 patients after weaning from mechanical ventilation.
Association between illness perception and adherence to inhaler therapy in elderly Chinese patients with chronic obstructive pulmonary disease.
Liu YR, Wang Y, Wang J … +1 more , Wang X
Chron Respir Dis · 2024 · PMID 39313240 · Full text
Despite the fact that inhaled medications serve as the foundation of chronic obstructive pulmonary disease (COPD) treatment, patient adherence to inhaler therapy remains low, significantly impacting health outcomes in di...
Despite the fact that inhaled medications serve as the foundation of chronic obstructive pulmonary disease (COPD) treatment, patient adherence to inhaler therapy remains low, significantly impacting health outcomes in disease management. The Common Sense Model of Self-Regulation suggests that illness perception plays a crucial role in individual behavior. Nevertheless, the relationship between illness perception and inhaler adherence, as well as the underlying mechanisms, remains unclear in the elderly Chinese COPD population. This study aimed to explore the correlation between dimensions of illness perception and adherence to inhaler therapy in elderly Chinese patients with COPD. A cross-sectional study was conducted by recruiting 305 participants (mean age: 70.96 years; 69.8% male) using convenience sampling from a tertiary hospital in Anhui, China. The Chinese versions of the Test of Adherence to Inhalers (TAI) and Brief Illness Perception Questionnaire (B-IPQ) were used to evaluate adherence to inhalation and perception of their illness in patients with COPD. Binary logistic regression analyses were used to explore the relationship between inhaler adherence and illness perception in patients with COPD. 84.3% of participants showed poor adherence, and the mean (standard deviation) B-IPQ total score was 44.87 (6.36). The results indicated an essential correlation between illness perception and inhaler adherence. Specifically, personal control (AOR = 2.149, < 0.001), treatment control (AOR = 1.743, < 0.001), comprehension (AOR = 5.739, < 0.001) and emotions (AOR = 1.946, < 0.001) within illness perception emerged as significant positive predictors for inhaler adherence among patients with COPD. This study suggests that clinical practitioners should monitor the illness perception of patients with COPD and develop targeted intervention measures to improve patient adherence to inhaler therapy.
Exploring the impact of comorbid dementia on exacerbation occurrence in general practice patients with chronic obstructive pulmonary disease.
de Kort NO, Bischoff EW, Ricking M … +1 more , Schermer TR
Chron Respir Dis · 2024 · PMID 39286846 · Full text
OBJECTIVE: Previous studies have shown an increased risk of dementia in patient with COPD, but whether comorbid dementia modifies the risk of exacerbations in patients with COPD is unknown. We explored exacerbation occur...
OBJECTIVE: Previous studies have shown an increased risk of dementia in patient with COPD, but whether comorbid dementia modifies the risk of exacerbations in patients with COPD is unknown. We explored exacerbation occurrence in patients with COPD with comorbid dementia and compared this to patients with COPD without comorbid dementia. METHODS: We performed a retrospective cohort study based on medical record data from 88 Dutch general practices. Patients diagnosed with COPD and comorbid dementia ( = 244, index group) were matched 1:1 to patients with COPD without comorbid dementia ( = 244, controls). Exacerbations were assessed 1 year before and 1 year after the dementia diagnosis (or corresponding date in controls) and compared between index and control groups by calculating Rate Ratios (RRs). RESULTS: Average number of COPD exacerbations after dementia diagnosis increased from 5 to 14 per 100 patient years in the index group (RR = 2.70, 95%CI 1.42-5.09; = 0.02) and from 17 to 30 per 100 patient years in the control group (RR = 1.74, 1.19-2.54; = 0.04). These RRs did not significantly differ between the index and control groups (RR ratio = 1.55, 0.74-3.25; = 0.25). DISCUSSION: We conclude that although the risk of exacerbation increased after patients with COPD were diagnosed with dementia, their change in exacerbation risk did not seem to differ from the change observed in patients with COPD without comorbid dementia. However, as our study was hypothesis-generating in nature, further investigations on the subject matter are needed.
A shared decision-making intervention for individuals living with chronic obstructive pulmonary disease who are considering the menu of pulmonary rehabilitation treatment options; a feasibility study.
Barradell AC, Doe G, Bekker HL … +3 more , Houchen-Wolloff L, Robertson N, Singh SJ
Chron Respir Dis · 2024 · PMID 39254860 · Full text
OBJECTIVES: Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasib...
OBJECTIVES: Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals. METHODS: Participants were recruited from Dec 2021-Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted. RESULTS: 13% of individuals [ = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals ( = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals' bias of centre-based PR, increased individuals' self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making. DISCUSSION: Results indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.
Exploring perceptions and expectations of COPD patients: A grounded theory approach for personalized therapeutic interventions.
Poletti V, Bresciani G, Banfi P … +1 more , Volpato E
Chron Respir Dis · 2024 · PMID 39241114 · Full text
This study aimed to investigate the dynamic patterns of perception and expectations among COPD patients. Conducted at the Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, in Milan, Italy, the r...
This study aimed to investigate the dynamic patterns of perception and expectations among COPD patients. Conducted at the Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, in Milan, Italy, the research involved 28 participants (16 males; mean age 72.8 ± 9.9) in face-to-face interviews. Utilizing a Grounded Theory approach, complemented by clinical data, recorded, and transcribed interviews underwent enhancement through the integration of two pictorial tools. The central theme that emerged was a profound sense of responsibility toward their condition, perceived as a significant threat to life. Key symptoms, such as shortness of breath, coupled with negative expectations about their condition, contributed to depressive mood and avoidance behaviors. A notable proportion ( = 17; 60.71%) of participants struggled to envision a positive future, expressing a pervasive sense of hopelessness, which significantly influenced their health behaviors and adherence to medical recommendations. Conversely, individuals who felt supported and optimistic about treatment efficacy exhibited more positive expectations and adopted proactive coping strategies. Recognizing the dynamic nature of patients' perceptions and negative illness expectations is essential to create personalized therapeutic interventions and meet the specific needs of COPD patients, ultimately improving the overall effectiveness of their care journey.
Diagnosed and undiagnosed cough-related stress urinary incontinence in women with refractory or unexplained chronic cough: Its impact on general health status and quality of life.
Arismendi E, Puente-Maestu L, Domingo C … +7 more , Dávila I, Quirce S, González-Barcala FJ, Crespo-Lessmann A, Sánchez-Jareño M, Rivas-Pardinas C, Cea-Calvo L
Chron Respir Dis · 2024 · PMID 39222070 · Full text
Stress urinary incontinence (SUI) is common in women with chronic cough but may be overlooked. To determine the frequency of underdiagnosis of cough-related SUI and its impact on women's general health status and qualit...
Stress urinary incontinence (SUI) is common in women with chronic cough but may be overlooked. To determine the frequency of underdiagnosis of cough-related SUI and its impact on women's general health status and quality of life (QoL). Data were analyzed for 147 women with refractory/unexplained chronic cough. Relevant details were collected from clinical charts and a patient-completed survey. General health status was assessed using the EuroQoL visual analogue scale (EQ-VAS) and QoL with the cough-specific Leicester Cough Questionnaire (LCQ). Women were classified into diagnosed ( 32; 21.8%) or undiagnosed ( 33; 22.4%) cough-related SUI, and no SUI ( 82; 55.6%) groups. Women with versus without cough-related SUI perceived poorer health status and greater impact of cough on everyday lives. Mean LCQ scores were significantly lower in cough-related SUI groups versus no SUI group. In multivariate analysis, the presence of cough-related SUI was significantly associated with lower EQ-VAS and LCQ scores. In our cohort, 44% of women had cough-related SUI, and half were undiagnosed. Irrespective of diagnosis, impairment to everyday lives and QoL was similar. Diagnosing cough-related SUI may identify additional patients who can benefit from therapies to suppress cough and improve QoL.
Clinically important changes and adverse events with centre-based or home-based pulmonary rehabilitation in chronic respiratory disease: A systematic review and meta-analysis.
Bondarenko J, Dal Corso S, Dillon MP … +5 more , Singh S, Miller BR, Kein C, Holland AE, Jones AW
Chron Respir Dis · 2024 · PMID 39187265 · Full text
To determine the proportion of people who achieve minimal clinically important differences (MCID) with centre-based or home-based pulmonary rehabilitation and to synthesise data on adverse events. Cochrane reviews and el...
To determine the proportion of people who achieve minimal clinically important differences (MCID) with centre-based or home-based pulmonary rehabilitation and to synthesise data on adverse events. Cochrane reviews and electronic databases were searched to identify randomised trials comparing centre-based to home-based pulmonary rehabilitation, or either model to usual care, in people with chronic respiratory disease. Primary outcomes were the proportion of participants achieving MCIDs in exercise capacity and disease-specific quality of life. Secondary outcomes were symptoms and adverse events. Cochrane Risk of Bias 1.0 and GRADE were used to assess the risk of bias and certainty of evidence respectively. Forty-nine trials were eligible. Compared to usual care, a higher proportion of pulmonary rehabilitation participants achieved the MCID for exercise capacity (6MWT: 47% vs 20%, = 0.11), dyspnoea (43% vs 29%, = 0.0001), fatigue (48% vs 27%, = 0.0002) and emotional function (37% vs 25%, = 0.02), with all of these between group differences statistically significant except for exercise capacity. There were no differences between centre-based and home-based pulmonary rehabilitation in the proportion of participants who achieved MCIDs (34%- 58% across studies). Ninety percent of trials reported no adverse events. Certainty of evidence was low-to- moderate with all outcomes except for CRQ-mastery (centre-based vs home-based pulmonary rehabilitation, or pulmonary rehabilitation vs usual care in COPD), ESWT (pulmonary rehabilitation vs usual care in COPD) and 6MWT (pulmonary rehabilitation vs usual care in bronchiectasis) where evidence was very uncertain. Clinically meaningful outcomes are achieved by similar proportions of participants in centre-based and home-based pulmonary rehabilitation, with few adverse events. Reporting of trial outcomes according to MCIDs is necessary for informed decision making regarding pulmonary rehabilitation models.
Development and initial validation of the ILD-Anxiety-Questionnaire (IAQ): A new instrument for assessing disease specific fears in interstitial lung disease.
Stenzel NM, Piel N, Kenn K … +1 more , Kreuter M
Chron Respir Dis · 2024 · PMID 39186048 · Full text
INTRODUCTION: Multiple studies focusing on chronic lung diseases (i.e. COPD), have indicated that the quality of life (QoL) can be impacted by disease-related fears. In the context of Interstitial Lung Diseases (ILD), ho...
INTRODUCTION: Multiple studies focusing on chronic lung diseases (i.e. COPD), have indicated that the quality of life (QoL) can be impacted by disease-related fears. In the context of Interstitial Lung Diseases (ILD), however, these have never been systematically examined. Therefore, the aim of the present study was to develop and evaluate an appropriate measuring tool, and to investigate the influence of disease-related anxieties on QoL in ILD. METHOD: = 166 ILD patients participated in the study and completed an itempool on disease-related fears, based on the COPD-Anxiety-Questionnaire (CAF-R) and expert assessments. Further, demographic and psychological variables were assessed (anxiety: GAD-7, QoL: K-BILD; Beliefs about Health: KKG). Psychometric properties were analyzed (factor structure, reliability, validity). Regression analyses were used to calculate the differential predictive power of disease-related anxieties on QoL. RESULTS: The factor structure was confirmed (Scales: Fear-of-Dependence-and-Progression, Fear-of-Social-Exclusion-and-Isolation, Fear-of-Physical-Activity, Fear-of-Dyspnea, and Sleep-related- Complaints). The Scales showed satisfying reliabilities (α = 0.68 to 0.89) and good validity. Disease-related anxieties proved to be differential predictors for different scales of the K-BILD (ß = -0.15 to ß = -0.58, all ps < .01). CONCLUSIONS: The ILD-Anxiety-Questionnaire (IAQ) is an easy-to-use, valid measurement tool for assessing disease-related anxieties. These vary in their impact on different aspects of QoL. Therefore, it might aid in specifying the indication for potential psychological supplementary interventions. Additional long-term studies are required to investigate how specific anxieties affect both overall and condition-specific QoL in diverse situations.
Factors influencing patient-provider communication about subjective cognitive decline in people with COPD: Insights from a national survey.
Stellefson M, Wang MQ, Campbell O
Chron Respir Dis · 2024 · PMID 39083760 · Full text
While there is a growing body of evidence indicating a relationship between COPD and cognitive impairment, there is a gap in evidence regarding discussions of cognitive symptoms in healthcare settings. This study investi...
While there is a growing body of evidence indicating a relationship between COPD and cognitive impairment, there is a gap in evidence regarding discussions of cognitive symptoms in healthcare settings. This study investigated the extent to which individuals with Chronic Obstructive Pulmonary Disease (COPD) and Subjective Cognitive Decline (SCD) self-reported confusion or memory loss with healthcare professionals. A secondary analysis of 2019 BRFSS data of US adults aged 45+ with COPD ( = 107,204), using logistic regression to explore associations between socio-demographic and health-related indicators with discussion of cognitive symptoms with healthcare professionals. Less than half (45.88%) of individuals reporting SCD discussed their cognitive symptoms with their healthcare provider. In the adjusted model, unemployed (AOR = 2.92, 95% CI: 1.70-5.02, < .005), retired (AOR = 3.16, 95% CI: 1.37-7.30, < .01), and current smokers (AOR = 1.73, 95% CI: 1.02-2.93, < .05) were more likely to discuss cognitive decline with a healthcare professional than their counterparts. In contrast, males (AOR = 0.53, 95% CI: 0.32-0.86, < .05) and binge drinkers (AOR = 0.49, 95% CI: 0.30-0.79, < .01) were significantly less likely to do so when compared to their counterparts. The study highlighted significant disparities in the likelihood of individuals with COPD discussing cognitive symptoms based on socio-demographic and health risk behaviors. Addressing gender disparities, occupational status, and personal health risks is crucial for improving patient-provider communication about SCD among adults with COPD.
A survey exploring the needs, preferences, and challenges of the key stakeholders for participating in and developing pulmonary rehabilitation in Pune, India.
Sahasrabudhe SD, Orme MW, Borade S … +9 more , Bhakare M, Modi M, Pina I, Ahmed Z, Padhye R, Barton A, Steiner MC, Salvi S, Singh SJ
Chron Respir Dis · 2024 · PMID 39075037 · Full text
Considering a huge burden of chronic respiratory diseases (CRDs) in India, there is a need for locally relevant Pulmonary rehabilitation (PR) services. This cross-sectional survey was aimed to explore the interest, needs...
Considering a huge burden of chronic respiratory diseases (CRDs) in India, there is a need for locally relevant Pulmonary rehabilitation (PR) services. This cross-sectional survey was aimed to explore the interest, needs and challenges among various stakeholders for PR in Pune city, India. At the outpatient respiratory medicine department of a multi-speciality hospital in Pune, India, 403 eligible people with CRDs were invited to participate in the survey, of which 370 (92%) responded and agreed to participate. (220 males, mean ± SD age 56 ± 15 years). Out of the 370, 323 (87%) people with CRDs were keen to attend PR. In a multiple selection question, there was inclination towards paper-based manuals home-based (70%) and web-based (84%) programs. 207 healthcare providers (HCPs), including physicians, pulmonologists and physiotherapists involved in the care of people living with CRDs across Pune city were invited to participate in the survey. Out of the 207, (80%) of the HCPs believed that PR was an effective management strategy and highlighted the lack of information on PR and need for better understanding of PR (48%) and its referral process. The surveyed stakeholders are ready to take up PR, identifying specific needs around further knowledge of PR, modes of delivery, and referral processes, that could potentially feed the development of relevant PR programs in the Indian healthcare settings.
Relevance of multidimensional dyspnea assessment in the context of pulmonary rehabilitation.
Molinier V, Moine E, Caille P … +3 more , Fernandes N, Alexandre F, Heraud N
Chron Respir Dis · 2024 · PMID 39046275 · Full text
While dyspnea is the main symptom in chronic obstructive pulmonary disease (COPD), it is often inadequately evaluated in pulmonary rehabilitation (PR), as it is typically measured using only the impact dimension (ID). Ho...
While dyspnea is the main symptom in chronic obstructive pulmonary disease (COPD), it is often inadequately evaluated in pulmonary rehabilitation (PR), as it is typically measured using only the impact dimension (ID). However, dyspnea is a multidimensional construct including perception (PD) and emotional (ED) domains. Our work aimed to study the complementarity of dyspnea dimensions and their respective ability to identify different evolutions during PR. 145 people with COPD attending PR were included in this retrospective study. Dyspnea scores from the modified Medical Research Council scale (ID) and the Multidimensional Dyspnea Profile questionnaire (PD/ED), exercise capacity, quality of life at the start (T1) and the end of PR (T2) were collected from existing databases/medical files. The evolution of each dyspnea dimension was evaluated using the delta score between T2-T1. PR response was defined using the minimal clinically important difference. Our results show that each dyspnea dimension was associated with different health-outcomes. Positive correlations were found between PD-ED at baseline and between their T2-T1 delta score (ρ = 0.51; ρ = 0.41 respectively, < .01), but there was no significant correlation between ID-PD or -ED ( > .05). 51% of the patients did not respond on ID, but 85% of them nonetheless responded on either PD or ED. Finally, 92% of patients responded on at least one dimension after PR. Our study emphasizes the significance of assessing each dimension of dyspnea independently and complementary, as dimensions are associated with different elements and evolve differently under PR effects. This approach is crucial to identifying weak points and allows professionals to focus on program elements that most effectively address the specific dimension causing problems.
Motivations for completing pulmonary rehabilitation - A qualitative analysis.
Harvey J, Ingram K, Edwards G … +5 more , Jenkins TO, Gardener G, Patel S, Man WD, Barker RE
Chron Respir Dis · 2024 · PMID 38901833 · Full text
Previous studies have focused on demographic factors that might predict non-completion of pulmonary rehabilitation (PR). We aimed to identify key modifiable factors that promote completion of PR. A mixed methods survey...
Previous studies have focused on demographic factors that might predict non-completion of pulmonary rehabilitation (PR). We aimed to identify key modifiable factors that promote completion of PR. A mixed methods survey was offered to participants completing a discharge assessment following PR. Descriptive statistics and inductive thematic analysis were used to analyse the survey responses, with investigator triangulation. 62 of 187 (33%) patients attending a PR discharge assessment between November 2022 and April 2023 returned the anonymised survey. Desire to improve health and wellbeing was the main reason for both initially committing to a course and for continuing with PR past transient thoughts of leaving. The positive impact of staff was the second most common reason. The enjoyment of the PR programme, being held accountable to attend classes, and the importance of other group members were other key themes identified. In conclusion, our findings suggest PR services need to implement strategies which ensure regular promotion and reinforcement of the health benefits of PR as well as implementation of PR modalities which best monopolise on the positive impact skilled staff have on motivating patients to complete PR.
Hospital and intensive care unit stay associated with body mass index affect cardiorespiratory fitness in patients with COVID-19.
Pleguezuelos E, Del Carmen A, Serra M … +3 more , Moreno E, Miravitlles M, Garnacho-Castaño MV
Chron Respir Dis · 2024 · PMID 38863283 · Full text
BACKGROUND: The effects of coronavirus disease 2019 (COVID-19) on the cardiorespiratory fitness of hospitalized and obese patients are of utmost relevance. This study aimed to analyze how hospital and intensive care unit...
BACKGROUND: The effects of coronavirus disease 2019 (COVID-19) on the cardiorespiratory fitness of hospitalized and obese patients are of utmost relevance. This study aimed to analyze how hospital and intensive care unit (ICU) stay together with body mass index affect cardiorespiratory fitness in patients with COVID-19. METHODS: 251 participants (males, = 118; females, = 133) were assigned to four groups: non-hospitalized COVID-19 patients ( = 65, age: 45.3 years), hospitalized COVID-19 patients ( = 63, age: 57.6 years), COVID-19 patients admitted to the ICU ( = 61, age: 56.9 years), and control group ( = 62, age: 49.8 years). An incremental cardiopulmonary exercise test was performed between 3 and 6 weeks after medical discharge from hospital. RESULTS: Higher peak oxygen uptake (VO), ventilatory efficiency and power output were found in ICU patients with normal weight (NW) than in overweight (OW) (Mean difference: 0.1 L·min, -5.5, 29.0 W, respectively) and obese (OB) ICU patients (Mean difference: 0.1 L·min, -5.0, 26.2 W, respectively) ( < .05). In NW, OW and OB participants, higher VO and power output were observed in control group compared with non-hospitalized (Mean difference: NW: 0.2 L·min, 83.3 W; OW: 0.2 L·min, 60.0 W; OB: 0.2 L·min, 70.9 W, respectively), hospitalized (Mean difference: NW: 0.2 L·min, 72.9 W; OW: 0.1 L·min, 58.3 W; OB: 0.2 L•min, 91.1 W, respectively) and ICU patients (Mean difference: NW: 0.1 L·min, 70.9 W; OW: 0.2 L·min, 91.1 W; OB: 0.3 L·min; 65.0 W, respectively) ( < .05). CONCLUSIONS: The degree of severity of COVID-19, especially identified by hospitalization and ICU stay, together with obesity and overweight were key factors in reducing cardiorespiratory fitness in patients with COVID-19.
Understanding the lived experience of idiopathic pulmonary fibrosis and how this shapes views on home-based pulmonary rehabilitation in Delhi, India.
Hanif H, Ahmed O, Manifield J … +8 more , Ishrat R, Pina I, Ahmed Z, Shibli M, Malcolm D, Talwar D, Singh SJ, Orme MW
Chron Respir Dis · 2024 · PMID 38787595 · Full text
OBJECTIVES: Pulmonary Rehabilitation (PR) is a high-impact intervention for individuals with idiopathic pulmonary fibrosis (IPF) but access is limited in India. PR barriers include distance to travel, lack of service pro...
OBJECTIVES: Pulmonary Rehabilitation (PR) is a high-impact intervention for individuals with idiopathic pulmonary fibrosis (IPF) but access is limited in India. PR barriers include distance to travel, lack of service provision and lack of healthcare professionals to deliver PR, thus it is disproportionate to the immense burden of IPF in India. We explored the lived experiences of people living with IPF, family caregivers (CGs) and healthcare workers (HCWs) as well as their views towards home-based PR (HBPR) in Delhi, India. METHODS: A qualitative study using semi-structured interviews with individuals with IPF (n = 20), CGs (n = 10) and HCWs (n = 10) was conducted. Data were analysed using codebook thematic analysis. RESULTS: Three major themes were generated: (i) Health impact, which included pathophysiological changes, range of symptoms experienced, disease consequences and impact of comorbidities; (ii) Disease management, which described strategies to control the progression and overall management of IPF, such as medications and exercises; (iii) Mode of Pulmonary Rehabilitation, which described perceptions regarding HBPR, comparisons with centre-based programmes, and how HBPR may fit as part of a menu of PR delivery options. CONCLUSION: People living with IPF, family caregivers and healthcare workers were positive about the potential implementation of HBPR and suggested the development of a paper-based manual to facilitate HBPR over digital/online approaches. The content of HBPR should be sensitive to the additional impact of non-IPF health issues and challenges of reduced interactions with healthcare professionals.
Effects of a respiratory and neurological rehabilitation treatment plan in post Covid-19 affected university students. Randomized clinical study.
Sánchez Milá Z, Rodríguez Sanz D, Martín Nieto A … +6 more , Jiménez Lobo A, Ramos Hernández M, Campón Chekroun A, Frutos Llanes R, Barragán Casas JM, Velázquez Saornil J
Chron Respir Dis · 2024 · PMID 38752418 · Full text
BACKGROUND: COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequel...
BACKGROUND: COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequelae are essential to improve respiratory function and thus quality of life, and the aim of this study is to evaluate the efficacy of a pulmonary and neurological rehabilitation program. OBJECTIVES: To apply a treatment to reduce dyspnea, increase exertional capacity, increase vital capacity and respiratory muscle strength, together with an increase in olfactory and gustatory sensitivity in post-SARS-CoV-2 patients. METHODS: A randomised controlled experimental study was conducted in 220 patients with a medical diagnosis of COVID-19 and more than 5 months of evolution, dyspnoea or perceived fatigue, including olfactory and gustatory perception problems, of whom 200 patients completed the study. 100 patients were randomly assigned to the intervention group, consisting of an inspiratory training treatment plan (Powerbreathe Plus®) combined with aerobic exercise and olfactory gustatory treatment for 31 days, and 100 patients to the control group, for 31 days without any type of therapy. RESULTS: The study was conducted in post-Covid-19 patients for 5 months. Two hundred patients were divided into an intervention group ( = 100) and a control group ( = 100). The comparison between the groups showed significant differences in spirometric variables; forced vital capacity ( < .001; Eta2 (0.439); Mean: 0,6135), the ratio between both FEV1/FVC ( < 0.01; Eta2 (0.728); Mean:9,313), peak inspiratory pressure ( < 0.01; Eta2 (0.906); Mean:4,526); changes were observed in dyspnoea measured with the modified Borg scale ( < 0.01; Eta2 (0.811); Mean:1,481) and the modified Medical Research Council scale ( < 0.01; Eta2 (0.881); Mean: 0.777); finally, changes were found in neurological variables, in the questions of the Singapore Smell and Taste Questionnaire, How was your sense of smell after treatment? ( < 0.01; Eta2 (0.813); Mean: 1,721) and How is your sense of taste after treatment? ( < 0.01; Eta2 (0.898); Mean: 1,088). CONCLUSION: The implementation of a respiratory rehabilitation treatment plan with the Powerbreathe Plus® device, aerobic exercise and neurorehabilitation with olfactory and gustatory training, is a therapeutic option against respiratory and neurological sequelae in patients who have suffered such sequelae due to the SARS-CoV-2 virus. Clinicaltrials.gov: NCT05195099. First posted 18/01/2022; Last Update Posted 29/06/2022.
Asthma and obstructive sleep apnea: Unveiling correlations and treatable traits for comprehensive care.
Pardo-Manrique V, Ibarra-Enríquez CD, Serrano CD … +2 more , Sanabria F, Fernandez-Trujillo L
Chron Respir Dis · 2024 · PMID 38717428 · Full text
Asthma and obstructive sleep apnea (OSA) are common respiratory disorders. They share characteristics such as airway obstruction, poor sleep quality, and low quality of life. They are often present as comorbidities, alon...
Asthma and obstructive sleep apnea (OSA) are common respiratory disorders. They share characteristics such as airway obstruction, poor sleep quality, and low quality of life. They are often present as comorbidities, along with obesity, gastroesophageal reflux disease (GERD), and allergic rhinitis (AR), which impacts the disease's control. In recent years, there has been discussion about the association between these conditions and their pathophysiological and clinical consequences, resulting in worse health outcomes, increased healthcare resource consumption, prolonged hospital stays, and increased morbidity and mortality. Some studies demonstrate that treatment with continuous positive airway pressure (CPAP) can have a beneficial effect on both pathologies. This review summarizes the existing evidence of the association between asthma and OSA at their pathophysiological, epidemiological, clinical, and therapeutic levels. It intends to raise awareness among healthcare professionals about these conditions and the need for further research.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe