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García-Ortiz JD, Cardona-Jiménez JL, Quijano-Almeida YM. La evaluación con el cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD - 6 como estrategia para el diagnóstico temprano de la EPOC en la atención primaria. IATREIA 2019. [DOI: 10.17533/udea.iatreia.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objetivo: evaluar el uso del cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD-6, como estrategia para el diagnóstico temprano de la enfermedad pulmonar obstructiva crónica (EPOC) en dos unidades de atención primaria de la empresa social del estado (E.S.E): Metrosalud, Medellín-Colombia en 2017. Métodos: estudio transversal de detección temprana de la EPOC, en personas mayores de 35 años sin diagnóstico previo de la enfermedad u otras complicaciones respiratorias subyacentes, a las cuales se les aplicó la prueba de tamizaje de COPD-PS para identificar factores de riesgo respiratorio y, posteriormente, la prueba de volumen espiratorio forzado (VEF1/VEF6) con el dispositivo portátil Vitalograph COPD-6. Resultados: de 1.485 pruebas de tamizaje COPD-PS, 198 presentaron un puntaje igual o superior a 4, por lo que se les realizó la prueba con el dispositivo Vitalograph. De los cuales, 147 (74,2 %) resultaron positivos. Discusión: el subregistro de la EPOC se describe actualmente como un grave problema mundial. El uso del cuestionario COPD-PS para la identificación de pacientes con factores de riesgo y del Vitalograph COPD-6 como prueba de función pulmonar, pueden ser herramientas útiles para implementar una estrategia efectiva en la reducción del subregistro de la EPOC.
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García-Olmos L, Alberquilla A, Ayala V, García-Sagredo P, Morales L, Carmona M, de Tena-Dávila MJ, Pascual M, Muñoz A, Salvador CH, Monteagudo JL. Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study. BMC FAMILY PRACTICE 2013; 14:11. [PMID: 23324308 PMCID: PMC3556139 DOI: 10.1186/1471-2296-14-11] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 01/14/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid. METHODS An observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid). The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs), and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated. RESULTS Prevalence of COPD in family medicine was 3.2% (95% CI 3.0-3.3) overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%), disorders of lipid metabolism (34%), obesity (25%), diabetes (20%) and arrhythmia (15%). After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity. CONCLUSIONS Patients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs.
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Affiliation(s)
- Luis García-Olmos
- Multiprofessional Education Unit for Family and Community Care (South-east), Hacienda de Pavones, 271, Madrid, 28030, Spain.
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Walters JA, Walters EH, Nelson M, Robinson A, Scott J, Turner P, Wood-Baker R. Factors associated with misdiagnosis of COPD in primary care. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2012; 20:396-402. [PMID: 21687918 DOI: 10.4104/pcrj.2011.00039] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIMS To assess the misclassification of chronic obstructive pulmonary disease (COPD) in Australian primary care. METHODS A cross-sectional study was performed in 31 (19%) practices in one Australian state. 341 patients with COPD (database diagnosis or current use of tiotropium plus GP confirmation) completed spirometry and questionnaires. Predictors of misclassification were investigated with multi-level mixed-effects logistic regression allowing for clustering by practice. RESULTS Spirometric confirmation of COPD (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio <0.7) was not present in 107 (31%) patients; 60 (56%) had normal lung function, seven (7%) had scalloped flow-volume curves and FEV1 <80% predicted, 40 (37%) had restriction (FVC <80% predicted). Among 107 misclassified patients the bronchodilators used were tiotropium in 26% and long-acting β2-agonists in 22%. The likelihood of misclassification increased with overweight/obesity (odds ratio (OR) 2.66; 95% CI 1.50 to 4.70) and self-reported allergic rhinitis/hay fever (OR 1.72; 95% CI 1.13 to 2.64) after adjustment for age, gender, and smoking. CONCLUSIONS Symptom-based diagnosis of COPD in primary care is unreliable, especially if patients are overweight, so diagnostic spirometry is essential to avoid inappropriate management.
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Affiliation(s)
- Julia A Walters
- Menzies Research Institute, University of Tasmania, Tasmania, Australia.
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Variability in the performing of spirometry and its consequences in the treatment of COPD in primary care. Arch Bronconeumol 2011; 47:226-33. [PMID: 21295903 DOI: 10.1016/j.arbres.2010.10.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/18/2010] [Accepted: 10/21/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND Several studies have approached the use of spirometry in the treatment of chronic obstructive pulmonary disease (COPD) in Primary Care (PC), but few have analysed its impact on the treatment of the patient with COPD. OBJECTIVES To evaluate the use of spirometry in the diagnosis and follow-up of COPD patients in PC, and its impact on treatment. To analyse the variation in the performing of spirometry between PC centres. METHODOLOGY A multicentre, observational and cross-sectional study of COPD patients seen in PC in Catalonia (Spain) during 2004-2005. A multilevel logistic regression model was used to identify factors associated with having spirometry and to determine the variation between the different centres. RESULTS Twenty-one centres which included 801 patients took part. Only 53.2% of them had a diagnostic spirometer available and the mean (standard deviation) FEV1(%) was 54.8% (18%). The registers of smoking habits, complementary tests and spirometry follow-up were more common among patients who had a diagnostic spirometry available compared to those who did not. No statistically significant differences were found as regards demographic, clinical, treatment and quality of life variables between patients with and without follow-up spirometry. Significant variation was observed in the percentage of diagnostic spirometries between different PC centres (variance=0.217; p<0.001). CONCLUSION Spirometry is underused in PC and performing it during follow-up is not associated to the different treatments received, or with a more complete approach to the disease. There is significant variation in the performing of spirometry among PC centres.
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Pellicer Císcar C, Soler Cataluña JJ, Andreu Rodríguez AL, Bueso Fabra J. Calidad del diagnóstico de la enfermedad pulmonar obstructiva crónica en el ámbito hospitalario. Arch Bronconeumol 2010; 46:64-9. [DOI: 10.1016/j.arbres.2009.10.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 10/08/2009] [Accepted: 10/26/2009] [Indexed: 11/28/2022]
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Císcar CP, Cataluña JJS, Rodríguez ALA, Fabra JB. Diagnosis of COPD in Hospitalised Patients. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1579-2129(10)70017-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Valero C, Monteagudo M, Llagostera M, Bayona X, Granollers S, Acedo M, Ferro JJ, Rodríguez-Latre L, Almeda J, Muñoz L. Evaluation of a combined strategy directed towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): information and health education feedback for improving clinical monitoring and quality-of-life. BMC Public Health 2009; 9:442. [PMID: 20128887 PMCID: PMC2799410 DOI: 10.1186/1471-2458-9-442] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 12/01/2009] [Indexed: 11/30/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a health problem that is becoming increasingly attended-to in Primary Care (PC). However, there is a scarcity of health-care programs and studies exploring the implementation of Clinical Practice Guidelines (CPG). The principal objective of the present study is to evaluate the effectiveness of a combined strategy directed towards health-care professionals and patients to improve the grade of clinical control and the quality-of-life (QoL) of the patients via a feedback on their state-of-health. A training plan for the health-care professionals is based on CPG and health education. Method/Design Multi-centred, before-after, quasi experimental, prospective study involving an intervention group and a control group of individuals followed-up for 12 months. The patients receive attention from urban and semi-urban Primary Care Centres (PCC) within the administrative area of the Costa de Ponent (near Barcelona). All the pacients corresponding to the PCC of one sub-area were assigned to the intervention group and patients from the rest of sub-areas to the group control. The intervention includes providing data to the health-care professionals (clinician/nurse) derived from a clinical history and an interview. A course of training focused on aspects of CPG, motivational interview and health education (tobacco, inhalers, diet, physical exercise, physiotherapy). The sample random includes a total of 801 patients (≥ 40 years of age), recorded as having COPD, receiving attention in the PCC or at home, who have had at least one clinical visit, and who provided written informed consent to participation in the study. Data collected include socio-demographic characteristics, drug treatment, exacerbations and hospital admissions, evaluation of inhaler use, tobacco consumption and life-style and health-care resources consumed. The main endpoints are dyspnoea, according to the modified scale of the Medical Research Council (MRC) and the QoL, evaluated with the St George's Respiratory Questionnaire (SGRQ). The variables are obtained at the start and the end of the intervention. Information from follow-up visits focuses on the changes in life-style activities of the patient. Discussion This study is conducted with the objective of generating evidence that shows that implementation of awareness programs directed towards health-care professionals as well as patients in the context of PC can produce an increase in the QoL and a decrease in the disease exacerbation, compared to standard clinical practice. Trial Registration Clinical Trials.gov Identifier: NCT00922545;
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Affiliation(s)
- Carles Valero
- Unit Methodology, Assessment and Quality, SAP Dreta, Catalan Health Institute, 08025 Barcelona, Spain.
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Carrasco-Garrido P, de Miguel-Díez J, Rejas-Gutierrez J, Martín-Centeno A, Gobartt-Vázquez E, Hernandez-Barrera V, de Miguel AG, Jimenez-Garcia R. Characteristics of chronic obstructive pulmonary disease in Spain from a gender perspective. BMC Pulm Med 2009; 9:2. [PMID: 19121205 PMCID: PMC2633274 DOI: 10.1186/1471-2466-9-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2008] [Accepted: 01/02/2009] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study was to analyze the clinical and management characteristics of chronic obstructive pulmonary disease (COPD) in men and women, to determine possible gender-associated differences between the two groups of patients. Methods An observational and descriptive epidemiological study (EPIDEPOC study). The study included patients with stable COPD and aged ≥ 40 years, evaluated in primary care. Data were collected relating to sociodemographic variables, clinical characteristics, quality of life (SF-12), severity of disease and treatment. The results obtained in men and women were compared. Results A total of 10,711 patients (75.6% males and 24.4% females) were evaluated. Significant differences were found between males and females in relation to the following parameters: age (67.4 ± 9.2 years in men vs 66.1 ± 10.8 in women, p < 0.05), smoking (91.9% of the men were smokers or ex-smokers vs 30% of the women), comorbidity (the frequency of hypertension, diabetes, anxiety and depression was greater in women, while ischemic heart disease was more common in men), mental component of quality of life (49.4 ± 10.3 in men vs 44.6 ± 11.9 in women, p < 0.05) and severity of disease (56.5 ± 13.3% in men vs 60.7 ± 3.2 in women, p < 0.05). As regards treatment, the percentage use of long-acting b2-adrenergic agonists, anticholinergic agents, theophyllines and mucolytic agents was significant greater in men. The total annual cost of COPD was greater in males than in females (1989.20 ± 2364.47 € vs 1724.53 ± 2106.90, p < 0.05). Conclusion The women with COPD evaluated in this study were younger, smoked less and have more comorbidity, a poorer quality of life, and lesser disease severity than men with COPD. However, they generated a lesser total annual cost of COPD than men.
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Viejo-Casas A, Almaraz-García M, Castillo-Obeso J. Calidad de las espirometrías en Atención Primaria de Cantabria. Semergen 2008. [DOI: 10.1016/s1138-3593(08)71902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Naberan K, De la Roza C, Lamban M, Gobartt E, Martín A, Miravitlles M. [Use of spirometry in the diagnosis and treatment of chronic obstructive pulmonary disease in primary care]. Arch Bronconeumol 2007; 42:638-44. [PMID: 17178068 DOI: 10.1016/s1579-2129(07)60006-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to assess the use of spirometry for the diagnosis and follow-up of patients with chronic obstructive pulmonary disease (COPD) in primary care in terms of deficiencies and the requirements for its correct use, and to identify the regimens most commonly used in patients with COPD. METHODS The study included 839 primary care physicians, each of whom completed 2 questionnaires, one on treatment of COPD and the other on the use of spirometry for diagnosis and follow-up of the disease. RESULTS Notable among the results was the high number of questionnaires in which no response was given to the question on classification of patients according to the severity of airway obstruction (10.7% of cases) and the low number of correct responses to questions on treatment with bronchodilators during the stable phase of COPD (15.1%). The highest rate of correct responses was for questions regarding the indication for spirometry, all of which were answered correctly in more than 60% of cases. Only 59.2% of primary health care centers performed spirometry, mainly due to a lack of training. In more than 30% of cases the nursing staff had not received specific training, a finding that was reflected in the poor compliance with guidelines for calibration (10.9% of health care centers performed daily calibrations), cleaning of the spirometer (in 13.9% of cases the equipment was never cleaned), and providing patients with pretest recommendations (30% did not provide recommendations the day before spirometry). CONCLUSIONS Primary care physicians are aware of the usefulness of spirometry for the diagnosis and follow-up of COPD. Although they are able to recognize airflow obstruction, they do not classify patients correctly in terms of severity. Very limited availability of spirometry was observed in primary health care centers and there was little training in the use of the technique, a finding reflected in the poor compliance with guidelines for its use.
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Affiliation(s)
- Karlos Naberan
- Grupo de Neumología de la Sociedad Catalana de Medicina de Familia, España
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Hueto J, Cebollero P, Pascal I, Cascante JA, Eguía VM, Teruel F, Carpintero M. [Spirometry in primary care in Navarre, Spain]. Arch Bronconeumol 2007; 42:326-31. [PMID: 16945262 DOI: 10.1016/s1579-2129(06)60541-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the use and quality of spirometry in primary care settings in Navarre, Spain. PATIENTS AND METHODS A questionnaire was completed simultaneously by professionals responsible for spirometry in all of the primary health care centers in Navarre. Data were collected on availability, model of spirometer, frequency of use, calibration, methods, personnel responsible for testing, and training of personnel. Then, baseline spirometry without a bronchodilator test was performed in 171 patients in their primary health care center and then the test was repeated on the same day in a hospital pneumology department. Spirometry was supervised by 2 pneumologists who jointly assessed the acceptability of the flow-volume curves. The quality of spirometry was assessed according to the recommendations of the American Thoracic Society and the interpretation of spirometry results according to the criteria of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). RESULTS A total of 90.9% of primary health care centers in Navarre have a spirometer, although 22% of those spirometers have never been used. Only 2 centers performed between 10 and 20 spirometry tests per week and none performed more than 20. In 96% of primary health care centers the spirometers were not regularly calibrated. The professionals who performed spirometry were not dedicated for that task in 51.2% of cases, and the mean period of supervised training was 10 hours. When comparisons were made between the mean values obtained in the primary care centers and the pneumology department, statistically significant differences were detected for forced vital capacity (P < .0001) and forced expiratory volume in the first second (P = .0002). Significant differences were also found between the flow-volume curves performed in the 2 different care settings for the initial and end portions of the curve as well as for the slope. The criteria for reproducibility recommended by the American Thoracic Society were not met in 76% of cases for forced vital capacity and 39.7% of cases for forced expiratory volume in the first second. Incorrect functional diagnosis occurred in 39.7% of spirometry tests and there was a tendency in the primary care settings to falsely diagnose patterns as restrictive and to inadequately classify the severity of obstruction. CONCLUSIONS Despite the fact that spirometers are available in the majority of primary health care centers in Navarre, we found a marked underuse of these devices and little compliance with recommendations for the use of spirometry. Furthermore, the quality of the measurements performed in this care setting was very low.
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Affiliation(s)
- Javier Hueto
- Sección de Neumología. Hospital Virgen del Camino. Pamplona. Navarra. España.
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Naberan K, de la Roza C, Lamban M, Gobartt E, Martín A, Miravitlles M. Utilización de la espirometría en el diagnóstico y tratamiento de la EPOC en atención primaria. Arch Bronconeumol 2006. [DOI: 10.1157/13095973] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Miravitlles M, de la Roza C, Naberan K, Lamban M, Gobartt E, Martín A, Chapman KR. [Attitudes toward the diagnosis of chronic obstructive pulmonary disease in primary care]. Arch Bronconeumol 2006; 42:3-8. [PMID: 16426516 DOI: 10.1016/s1579-2129(06)60106-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although the prevalence of chronic obstructive pulmonary disease (COPD) has increased among women, it is still considered a disease that mainly affects men. This study aimed to identify the diagnostic attitudes of primary care physicians toward patients with COPD according to gender and spirometric results. METHODS A representative sample of 839 primary care physicians participated in the study. Each physician dealt with 1 of 8 hypothetical cases based on a patient diagnosed with COPD. In half the cases, the physician was told the patient was a man. The other half of the physicians were told the same patient was a woman. After presentation of the medical history and results of physical examination, the physicians were asked to state a probable diagnosis and indicate the diagnostic tests that were necessary. They were then told the results of spirometry, which indicated obstruction ranging from moderate to severe. Negative results of bronchodilator tests and oral corticosteroid tests were then communicated. RESULTS COPD was more likely to be the preliminary diagnosis for male patients than for females (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.15-2.1). This gender bias disappeared once the physicians were shown the abnormal results of spirometry. Patients with severe obstruction were more likely to be diagnosed with COPD than those with moderate obstruction (OR, 1.5; 95% CI, 1.08-2.09). CONCLUSIONS There is gender bias in the diagnosis of COPD. Patients with moderate obstruction are often believed not to have COPD. These biases may compromise the early diagnosis of the disease in a group of patients with ever increasing risk.
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Affiliation(s)
- M Miravitlles
- Servicio de Neumología, Institut Clínic del Tòrax, Hospital Clínic, Barcelona, Spain.
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Rodríguez-Pascual L, Cordero-Guevara J, Viejo-Bañuelos J. Estudio de la concordancia de 2 aparatos para la medida del PEF y FEV1: neumotacógrafo y PiKo-1. Arch Bronconeumol 2006. [DOI: 10.1157/13085565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rodríguez-Pascual L, Cordero-Guevara J, Viejo-Bañuelos JL. Agreement Between Pneumotachograph and PiKo-1 Measurements of PEF and FEV1. ACTA ACUST UNITED AC 2006; 42:144-7. [PMID: 16545254 DOI: 10.1016/s1579-2129(06)60134-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess how well values for peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1) agree when measured with the PiKo-1 device and with a conventional pneumotachograph. PATIENTS AND METHODS This randomized, single-blind study included 40 patients who attended the clinic for lung function testing. The 2 measurement devices were the Masterlab pneumotachograph and the PiKo-1. A correction factor estimated by the manufacturer was applied to the measurements taken with the PiKo-1. RESULTS The values obtained with the 2 devices differed by a mean of 5.8218 L/min for PEF (95% confidence interval [CI], -9.4809 to 21.1387) and 0.001 L for FEV1 (95% CI, -0.0616 to 0.0636). The intraclass correlation coefficient was 0.9652 (95% CI, 0.9336-0.9819) for PEF and 0.9876 (95% CI, 0.9761-0.9936) for FEV1. CONCLUSIONS The PiKo-1 is a simple and easy-to-use device that can be very useful for monitoring and assessing the severity of obstructive pulmonary diseases. The results must be corrected for altitude and the estimated correction factor should be applied.
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Miravitlles M, de la Roza C, Naberan K, Lamban M, Gobartt E, Martín A, Chapman K. Problemas con el diagnóstico de la EPOC en atención primaria. Arch Bronconeumol 2006. [DOI: 10.1157/13083272] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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de Miguel Díez J. [Health care costs of asthma and chronic obstructive pulmonary disease]. Arch Bronconeumol 2005; 41:239-41. [PMID: 15919003 DOI: 10.1016/s1579-2129(06)60216-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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de Miguel Díez J, Izquierdo Alonso JL, Molina París J, Bellón Cano JM, Rodríguez González-Moro JM, de Lucas Ramos P. Factors Affecting Drug Prescription in Patients With Stable COPD: Results From a Multicenter Spanish Study. ACTA ACUST UNITED AC 2005; 41:63-70. [PMID: 15717999 DOI: 10.1016/s1579-2129(06)60399-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine what factors are associated with prescription of drugs to patients with stable chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS We studied 568 patients with stable COPD. Assessments included determination of the severity of dyspnea, body mass index, health-related quality of life, and spirometry testing. RESULTS The forced expiratory volume in 1 second was significantly associated with prescription of long-acting beta2-adrenergic agonists (odds ratio [OR]=0.98; 95% confidence interval [CI], 0.96-1) and inhaled corticosteroids (OR=0.98; 95% CI, 0.96-1). Quality of life was related to administration of short-acting beta2-adrenergic agonists (OR=1.02; 95% CI, 1-1.03), long-acting beta2-adrenergic agonists (OR=1.02; 95% CI, 1-1.03), ipratropium bromide (OR=1.03; 95% CI, 1-1.04), theophylline drugs (OR=1.02; 95% CI, 1-1.03), and inhaled corticosteroids (OR=1.02; 95% CI, 1-1.03). The severity of dyspnea was significantly associated with prescription of oral corticosteroids (for grade IV dyspnea, OR=15.25; 95% CI, 2.40-97.02). Body mass index was not related to drug administration. CONCLUSIONS Drug prescription in patients with stable COPD correlates not only with forced expiratory volume in 1 second but also with other parameters such as health-related quality of life and dyspnea.
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Affiliation(s)
- J de Miguel Díez
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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de Miguel Díez J, Izquierdo Alonso J, Molina París J, Bellón Cano J, Rodríguez González-Moro J, de Lucas Ramos P. Factores determinantes de la prescripción farmacológica en los pacientes con EPOC estable. Resultados de un estudio multicéntrico español (IDENTEPOC). Arch Bronconeumol 2005. [DOI: 10.1157/13070801] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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de Miguel Díez J, Izquierdo Alonso J, Rodríguez González-Moro J, de Lucas Ramos P, Bellón Cano J, Molina París J. Quality of Life With Chronic Obstructive Pulmonary Disease: the Influence of Level of Patient Care. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1579-2129(06)60351-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Díaz Lobato S, Mayoralas Alises S. Análisis de las publicaciones sobre la EPOC en ARCHIVOS DE BRONCONEUMOLOGÍA 2 años después de la designación del Año EPOC. Arch Bronconeumol 2004. [DOI: 10.1016/s0300-2896(04)75595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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de Miguel Díez J, Izquierdo Alonso J, Rodríguez González-Moro J, de Lucas Ramos P, Bellón Cano J, Molina París J. Calidad de vida en la enfermedad pulmonar obstructiva crónica. Influencia del nivel de asistencia de los pacientes. Arch Bronconeumol 2004. [DOI: 10.1016/s0300-2896(04)75567-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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