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Kham-Ai P, Li P, Wheeler P, Witt C, Sanderson W, Heaton K. Respiratory Symptoms and Psychological Distress in Farmers Living With Chronic Obstructive Pulmonary Disease. Workplace Health Saf 2024:21650799241267828. [PMID: 39099544 DOI: 10.1177/21650799241267828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
BACKGROUND Farmers with chronic obstructive pulmonary disease (COPD) often face both respiratory issues and psychological distress, which can exacerbate their condition. However, no prior research has examined how the frequency of respiratory symptoms is associated to psychological distress in these individuals. Therefore, this study aimed to explore this relationship among U.S. farmers living with COPD. METHODS A cross-sectional study involved 101 participants, a mix of on-site and online recruits, assessing respiratory symptoms and psychological distress in farmers with COPD. The study employed standard self-reported measures and utilized both simple and multiple linear regression to analyze the association between respiratory symptoms and psychological distress. FINDINGS Participants reported notably higher levels of respiratory symptoms (61.6 [SD = 13.3]) compared to the reference score of 12, along with elevated psychological distress (25.9 [SD = 10.6]). Factors like COPD duration, income, smoking, and emergency department (ED) visits correlated with respiratory symptoms, while age, COPD duration, income, smoking, pesticide exposure, and farm type were associated to psychological distress. Notably, even after accounting for age, smoking, and pesticide exposure, a significant association remained between respiratory symptoms and psychological distress (β = 0.46, p < .001). CONCLUSION Respiratory symptoms were significantly associated to psychological distress, even when considering other factors. While this aligns with existing research, a future longitudinal study is crucial to establish the cause-effect relationship between these variables. Understanding this relationship could inform the development of targeted interventions to alleviate psychological distress in individuals with respiratory symptoms. IMPLICATIONS FOR OCCUPATIONAL HEALTH NURSING PRACTICE The correlation between COPD symptoms and psychological distress in farmers emphasizes the need for integrated nursing care. Occupational health nurses should prioritize combined respiratory and mental health assessments.
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Affiliation(s)
| | - Peng Li
- School of Nursing, University of Louisville
| | | | | | - Wayne Sanderson
- Department of Epidemiology and College of Agriculture, Food and Environment, University of Kentucky
| | - Karen Heaton
- School of Nursing, The University of Alabama at Birmingham
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Vafai-Tabrizi F, Schwab U, Brecht S, Funk GC. Adjustments to maintenance therapy and the reasoning behind them among COPD outpatients in Austria: the STEP study. ERJ Open Res 2024; 10:00615-2023. [PMID: 38333644 PMCID: PMC10851946 DOI: 10.1183/23120541.00615-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/08/2023] [Indexed: 02/10/2024] Open
Abstract
Background Adjustments to COPD maintenance treatment are based on different guidelines. In Austria, there is a lack of real-world data on treatment adjustments of COPD outpatients and their underlying rationale. The STEP study characterised change patterns of pharmacological maintenance therapy in COPD outpatients in predefined categories of step-up, step-down and switch, the underlying reasons, and predictors in clinical routine in Austria. Methods STEP was a single-visit non-interventional study in Austria. 77 pulmonologists based in outpatient clinics documented previous and adapted COPD therapy, reason for change, patient characteristics, COPD phenotype, and lung function. Patients' COPD symptom burden was assessed by using the COPD Assessment Test (CAT). Predictors for therapy changes were identified. Results 1137 patients were studied (mean±sd age 67±10 years; 56.9% male; mean forced expiratory volume in 1 s 56.3% predicted; Global Initiative for Chronic Obstructive Lung Disease B and E stages 66% and 19%, respectively; mean CAT score 17.5). Therapy step-up was observed in 59.3%, treatment switch in 21.7% and step-down in 19.0% of patients. Triple therapy comprised the biggest proportion of inhalation treatment (53.3%). Physicians reported lung function, symptom burden and exacerbations as the main reasons for step-up or step-down, whereas switches within the same treatment class were predominantly caused by device issues. Predictors for step-up were comorbid asthma and exacerbations among others. Conclusions STEP was the first study to investigate COPD therapy changes in clinical routine in Austria. The most frequent treatment adjustment was step-up, followed by treatment switch and step-down. Symptom burden, stable or improved lung function and inhalation device handling were the most frequently given reasons for adjustments.
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Affiliation(s)
- Florian Vafai-Tabrizi
- Karl Landsteiner Institute for Lung Research and Pulmonary Oncology and 2nd Medical Department with Pneumology, Klinik Ottakring, Vienna, Austria
| | | | | | - Georg-Christian Funk
- Karl Landsteiner Institute for Lung Research and Pulmonary Oncology and 2nd Medical Department with Pneumology, Klinik Ottakring, Vienna, Austria
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Horner A, Olschewski H, Hartl S, Valipour A, Funk GC, Studnicka M, Merkle M, Kaiser B, Wallner EM, Brecht S, Lamprecht B. Physical Activity, Depression and Quality of Life in COPD - Results from the CLARA II Study. Int J Chron Obstruct Pulmon Dis 2023; 18:2755-2767. [PMID: 38050481 PMCID: PMC10693753 DOI: 10.2147/copd.s435278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/01/2023] [Indexed: 12/06/2023] Open
Abstract
Background Symptoms of depression, pain and limitations in physical activity may affect quality of life in COPD patients independent from their respiratory burden. We aimed to analyze the associations of these factors in outpatients with COPD in Austria in a stable phase of disease. Methods We conducted a national, cross-sectional study among patients with COPD. For depression, the Patient Health Questionnaire-9 (PHQ-9) and for respiratory symptoms the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) were used along with 10-point scales for physical activity and pain. Results After exclusion of 211 patients due to non-obstructive spirometry or missing data, 630 patients (62.5% men; mean age 66.8 ± 8.6 (SD) years; mean FEV1%pred. 54.3 ± 16.5 (SD)) were analyzed. Of these, 47% reported one or more exacerbations in the previous year, 10.4% with hospitalization. A negative depression score was found in 54% and a score suggesting severe depression (PHQ-9 score ≥ 15) in 4.7%. In a multivariate linear regression model, self-reported pain, dyspnea, and number of exacerbations were predictors for higher PHQ-9-scores. A negative pain score was found in 43.8%, and a score suggesting severe pain in 2.9% (8-10 points of 10-point scale). Patients reporting severe pain were more often female, had more exacerbations, and reported more respiratory and depressive symptoms, a lower quality of life, and less physical activity. About 46% of patients rated their physical activity as severely impaired. These patients were significantly older, had more exacerbations, concomitant heart disease, a higher pain and depression score, and a lower quality of life (SGRQ-C - total score and all subscores). Conclusions In Austria, nearly half of stable COPD outpatients reported symptoms of depression, which were associated with lower levels of self-reported physical activity, more pain, and respiratory symptoms. The associations were particularly strong for depression with SGRQ-C.
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Affiliation(s)
- Andreas Horner
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
| | - Horst Olschewski
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, and Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine, Klinik Penzing and Sigmund Freud University, Medical School, Vienna, Austria
| | - Arschang Valipour
- Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Georg-Christian Funk
- Department of Internal and Respiratory Medicine, Klinik Ottakring, Vienna, Austria
| | - Michael Studnicka
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Monika Merkle
- Specialist Office for Pulmonology Dr. Merkle, Vienna, Austria
| | - Bernhard Kaiser
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
| | | | | | - Bernd Lamprecht
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
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Jarab AS, Al-Qerem W, Alzoubi KH, Abu Heshmeh S, Mukattash TL, Naser AY, Al Hamarneh YN. Health-related quality of life and its associated factors in patients with chronic obstructive pulmonary disease. PLoS One 2023; 18:e0293342. [PMID: 37883370 PMCID: PMC10602230 DOI: 10.1371/journal.pone.0293342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE The present study aimed to evaluate HRQOL and to explore the factors associated with poor HRQOL among patients with COPD. METHODS In the present cross-sectional study, the validated St George's Respiratory Questionnaire for COPD patients (SGRQ-C) was used to evaluate HRQOL among 702 patients with COPD at two major hospitals in Jordan in the period between January and April 2022. Quantile regression analysis was used to explore the factors associated with HRQOL among the study participants. RESULTS According to SGRQ-C, the HRQOL of the study participants was greatly impaired with a total SGRQ of 55.2 (34-67.8). The highest impairment in the HRQOL was in the impact domain with a median of 58.7 (29-76.3). Increased number of prescribed medications (β = 1.157, P<0.01), older age (β = 0.487, P<0.001), male gender (β = 5.364, P<0.01), low education level (β = 9.313, P<0.001), low and moderate average income (β = 6.440, P<0.05, and β = 6.997, P<0.01, respectively) were associated with poorer HRQOL. On the other hand, being married (β = -17.122, P<0.001), living in rural area (β = -6.994, P<0.01), non-use of steroids inhalers (β = -3.859, P<0.05), not receiving long acting muscarinic antagonists (LAMA) (β = -9.269, P<0.001), not receiving LABA (β = -8.243, P<0.001) and being adherent to the prescribed medications (β = -6.016, P<0.001) were associated with improved HRQOL. Furthermore, lower disease severity (stage A, B, and C) (β = -23.252, -10.389, and -9.696 respectively, P<0.001), and the absence of comorbidities (β = -14.303, P<0.001) were associated with better HRQOL. CONCLUSIONS In order to maximize HRQOL in patients with COPD, future COPD management interventions should adopt a multidisciplinary approach involving different healthcare providers, which aims to provide patient-centered care, implement personalized interventions, and improve medication adherence, particularly for patients who are elderly, males, have low socioeconomic status, receive multiple medications and have multiple comorbid diseases.
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Affiliation(s)
- Anan S. Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Yazid N. Al Hamarneh
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Batte C, Semulimi AW, Mutebi RK, Twinamasiko N, Muyama SR, Mukisa J, Atukunda I, Mukunya D, Kalyesubula R, Trishul S, Kirenga B. Cross-sectional validation of the COPD Assessment Test (CAT) among chronic obstructive pulmonary disease patients in rural Uganda. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002013. [PMID: 37276227 DOI: 10.1371/journal.pgph.0002013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023]
Abstract
Measuring quality of life is a key component in the management of Chronic Obstructive Pulmonary Disease (COPD). The COPD assessment test (CAT), an easy to administer and shorter instrument than the standard Saint George's respiratory questionnaire (SGRQ), could be an alternative tool for measuring the quality of life of COPD patients in rural Uganda. A cross-sectional study was conducted between June and August 2022, consecutively recruiting 113 COPD patients aged > 40 years from the Low-Dose Theophylline for the management of Biomass-associated COPD (LODOT-BCOPD) study. Upon obtaining consent, participants answered an interviewer administered social demographic, CAT and SGRQ questionnaire. Internal consistency for both SGRQ and CAT was determined using Cronbach's alpha coefficient and values > 0.7 were considered acceptable while correlations were determined using Spearman's rank correlation. Limits of Agreement were visualised using Bland Altman and pair plots. Of the 113 participants, 51 (45.1%) were female. The mean age was 64 ± 12 years, 19 (16.8%) had history of smoking while majority (112 (99.1%)) reported use of firewood for cooking. There was a strong correlation of 0.791 (p < 0.001) between the CAT and SGRQ total scores with a high internal consistency of CAT, Cronbach's alpha coefficient of 0.924 (0.901-0.946). The agreement between the absolute CAT scores and the SGRQ scores was good with a mean difference of -0.932 (95% Confidence Interval: -33.49-31.62). In summary, CAT has an acceptable validity and can be used as an alternative to the SGRQ to assess the quality of life of COPD patients in rural Uganda.
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Affiliation(s)
- Charles Batte
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Climate Change and Health Unit, Tree Adoption Uganda, Kampala, Uganda
| | - Andrew Weil Semulimi
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ronald Kasoma Mutebi
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Ugand
- Department of Medicine, Mengo Hospital, Kampala, Uganda
| | - Nelson Twinamasiko
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Ugand
| | - Sarah Racheal Muyama
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John Mukisa
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Kampala, Uganda
| | - Immaculate Atukunda
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Mukunya
- Faculty of Health Sciences, Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Robert Kalyesubula
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- African Community Centre for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - Siddharthan Trishul
- Division of Pulmonary, Allergy, Critical Care, and Sleep, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Bruce Kirenga
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Czira A, Purushotham S, Iheanacho I, Rothnie KJ, Compton C, Ismaila AS. Burden of Disease in Patients with Mild or Mild-to-Moderate Chronic Obstructive Pulmonary Disease (Global Initiative for Chronic Obstructive Lung Disease Group A or B): A Systematic Literature Review. Int J Chron Obstruct Pulmon Dis 2023; 18:719-731. [PMID: 37151760 PMCID: PMC10155715 DOI: 10.2147/copd.s394325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Background Patients with mild or mild-to-moderate chronic obstructive pulmonary disease (COPD), defined as Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A/B, are regarded as having a lower risk of experiencing multiple or severe exacerbations compared with patients classified as GOLD group C/D. Current guidelines suggest that patients in GOLD A/B should commence treatment with a bronchodilator; however, some patients within this population who have a higher disease burden may benefit from earlier introduction of dual bronchodilator or inhaled corticosteroid-containing therapies. This study aimed to provide research-based insights into the burden of disease experienced by patients classified as GOLD A/B, and to identify characteristics associated with poorer outcomes. Methods A systematic literature review (SLR) was conducted to identify evidence (burden of disease and prevalence data) relating to the population of interest (patients with COPD classified as GOLD A/B). Results A total of 79 full-text publications and four conference abstracts were included. In general, the rates of moderate and severe exacerbations were higher among patients in GOLD group B than among those in group A. Among patients classified as GOLD A/B, the risk of exacerbation was higher in those with more symptoms (modified Medical Research Council or COPD Assessment Test scales) and more severe airflow limitation (forced expiratory volume in 1 second % predicted). Conclusion Data from this SLR provide clear evidence of a heavier burden of disease for patients in GOLD B, compared with those in GOLD A, and highlight factors associated with worse outcomes for patients in GOLD A/B.
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Affiliation(s)
- Alexandrosz Czira
- Value Evidence and Outcomes, R&D Global Medical, GSK, Brentford, UK
- Correspondence: Alexandrosz Czira, Value Evidence and Outcomes, R&D Global Medical, GSK, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UK, Tel +44 7788 351610, Email
| | | | | | - Kieran J Rothnie
- Value Evidence and Outcomes, R&D Global Medical, GSK, Brentford, UK
| | | | - Afisi S Ismaila
- Value Evidence and Outcomes, GSK, Collegeville, PA, USA
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Grosbois JM, Gephine S, Kyheng M, Le Rouzic O, Chenivesse C. Improving the wellbeing of caregivers of patients with COPD using a home-based pulmonary rehabilitation programme. ERJ Open Res 2022; 8:00255-2022. [PMID: 36655219 PMCID: PMC9835991 DOI: 10.1183/23120541.00255-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/11/2022] [Indexed: 01/21/2023] Open
Abstract
Objectives The aim of this study was to evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on anxiety and depressive symptoms, general fatigue and burden in informal caregivers of patients with COPD. We also evaluated the baseline characteristics of both patients and caregivers that contributed to the change in caregiver's outcomes after PR. Methods In this retrospective study, patients with COPD were referred to an 8-week home-based PR programme consisting of a weekly supervised 90-min session. Informal caregivers were invited to participate in PR according to the patient's preference and its availability. Caregivers received educational support, behavioural therapies and self-management strategies using the same methods as for patients. Burden, anxiety and depressive symptoms, and general fatigue of caregivers were assessed at baseline and at the end of PR. Results 241 patients with COPD and 138 (57.3%) caregivers were included. The majority of the caregivers were women (70.5%) and spouses (90.3%) and had at least three comorbidities (57.3%). A large proportion of caregivers showed baseline high burden, anxiety symptoms and abnormal fatigue (40%, 40% and 45%, respectively). Burden, anxiety and depressive symptoms, and general fatigue of informal caregivers were all improved after PR (p<0.05). Long-term oxygen therapy and/or noninvasive ventilation, coronaropathy and/or peripheral arterial disease and a higher baseline modified Medical Research Council Dyspnoea scale score in patients with COPD were associated with a decrease in caregiver's burden after PR. Conclusion A large proportion of caregivers of patients with COPD showed anxiety symptoms, fatigue and a high burden. These outcomes were improved by integrating the caregiver into a home-based PR programme.
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Affiliation(s)
| | - Sarah Gephine
- Univ. Lille, Univ. Artois, Univ. Littoral Côte D'opale, ULR 7369-URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | - Maeva Kyheng
- CHU Lille, Department of Biostatistics, Univ. Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Lille, France
| | - Olivier Le Rouzic
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille, France,Univ. Lille, Lille, France
| | - Cécile Chenivesse
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille, France,Univ. Lille, Lille, France
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8
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Alnahdi AH, Albarrati A. The Arabic version of the Lower Extremity Functional Scale is a reliable and valid measure of activity limitation in people with chronic obstructive pulmonary disease. Disabil Rehabil 2022; 44:8487-8492. [PMID: 34958611 DOI: 10.1080/09638288.2021.2019842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To examine the psychometric properties of the Arabic version of the Lower Extremity Functional Scale (LEFS-Ar) in people with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS Stable individuals with COPD (N = 70) confirmed by spirometry were asked to complete the LEFS-Ar, St George's Respiratory Questionnaire (SGRQ) and performed the Six-Minute Walk Test (6MWT). Participants were also asked to complete LEFS-Ar for the second time within 10 days. The LEFS-Ar floor and ceiling effects, internal consistency, test-retest reliability, measurement error, and construct validity were examined. RESULTS The LEFS-Ar had excellent internal consistency with Cronbach's alpha of 0.95 and excellent test-retest reliability (ICCagreement=0.91) with no floor and ceiling issues. Standard error of measurement was 4.78 points while the minimal detectable change at 90% confidence was 11.15 points. Consistent with our hypotheses, the LEFS-Ar scores correlated significantly with 6MWT (r= -0.66, p < 0.001), activity domain of the SGRQ (r = 0.55, p < 0.001), and were significantly different according to COPD disease severity (p= 0.02). CONCLUSIONS In people with COPD, the LEFS-Ar has excellent reliability with no floor or ceiling effects. The LEFS-Ar demonstrated evidence supporting its validity as a measure of activity limitation that can be used in clinical practice and in research studies.Implications for rehabilitationThe Arabic version of the Lower Extremity Functional Scale (LEFS-Ar) is a reliable measure in people with chronic obstructive pulmonary disease (COPD).Rehabilitation specialists can use the LEFS-Ar to validly measure activity limitation in people with COPD.
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Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali Albarrati
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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9
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Altawalbeh SM, Almomani BA, Alefan Q, Mohammad Momany S, Al-Share QY. The influence of adverse drug effects on health-related quality of life in chronic obstructive pulmonary disease patients. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:457-465. [PMID: 35849340 DOI: 10.1093/ijpp/riac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 05/23/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Concerns have been raised about the influence of adverse drug effects on patient's health-related quality of life (HRQoL) in COPD patients. This study aimed to evaluate the impact of COPD treatment-related adverse effects on HRQoL in COPD patients. METHODS In a cross-sectional study, COPD patients aged 40 years or older were identified and interviewed during their hospital visits. The EuroQol 5 Dimension 5 Level (EQ-5D-5L) questionnaire was used for evaluating HRQoL. Potential treatment adverse effects were evaluated as experienced by participants during the last 2 weeks preceding the interview. The intensity of adverse effects was reported in the following categories: never, mild, moderate and severe. Multivariable linear regression model was performed to evaluate the influence of adverse drug effects on utility scores as an indicator of HRQoL. KEY FINDINGS A total of 203 patients diagnosed with COPD were recruited in the current study. The mean utility score of the study sample was 0.68 (SD = 0.36). Moderate-severe constipation, moderate-severe confusion, mild urinary hesitation, moderate-severe urinary hesitation, moderate-severe dry eyes and moderate-severe drowsiness were significant predictors/determinants for the average utility scores (coefficients were -0.099, -0.191, -0.111, -0.157 and -0.144, respectively). In addition, having higher COPD Assessment Test scores and severe disease was negatively associated with average utility scores (coefficients were -0.287 and -0.124, respectively). CONCLUSIONS Higher intensity of COPD treatment-related adverse effects has a negative influence on HRQoL in COPD patients. Anticholinergic drug effects are of concern in COPD adults' population.
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Affiliation(s)
- Shoroq M Altawalbeh
- Department of Clinical Pharmacy, School of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Basima A Almomani
- Department of Clinical Pharmacy, School of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Qais Alefan
- Department of Clinical Pharmacy, School of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Suleiman Mohammad Momany
- Department of Internal Medicine, School of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Qusai Y Al-Share
- Department of Clinical Pharmacy, School of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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10
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Olortegui-Rodriguez JJ, Soriano-Moreno DR, Benites-Bullón A, Pelayo-Luis PP, Huaringa-Marcelo J. Prevalence and incidence of chronic obstructive pulmonary disease in Latin America and the Caribbean: a systematic review and meta-analysis. BMC Pulm Med 2022; 22:273. [PMID: 35842603 PMCID: PMC9288210 DOI: 10.1186/s12890-022-02067-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) remains one of the leading causes of morbidity and mortality worldwide, and its epidemiology in Latin America and the Caribbean is not well described. The aim of this study was to evaluate the prevalence and incidence of COPD in Latin America and the Caribbean. METHODS We searched systematically in Web of Science (WoS)/Core Collection, WoS/MEDLINE, WoS/Scielo, Scopus, PubMed, and Embase from 2010 to 2021. Studies assessing the prevalence and incidence of COPD according to the GOLD classification were included. The overall prevalence of COPD was calculated as a function of the general population using a random-effects model. RESULTS 20 studies (19 cross-sectional and 1 cohort) met the inclusion criteria. The prevalence of COPD in the general population older than 35 years was 8.9%. The prevalence in men was 13.7% and in women 6.7%. The prevalence in smokers and ex-smokers was 24.3%. The incidence in the general population of COPD according to one study was 3.4% at 9 years of follow-up. CONCLUSIONS COPD is prevalent in Latin America, especially in men and in smokers and ex-smokers. Further prevalence and incidence studies in the general population are needed, as well as health policies and strategies to address the disease.
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Affiliation(s)
- Juan J Olortegui-Rodriguez
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru.
| | - Alejandro Benites-Bullón
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | - Pilar P Pelayo-Luis
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | - Jorge Huaringa-Marcelo
- Facultad de Medicina Humana, Universidad Científica del Sur, Lima, Peru
- Hospital Nacional Arzobispo Loayza, Lima, Peru
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11
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Raddadi Y, Adib-Hajbaghery M. Health literacy and quality of life in Iranian persons with COPD. Heart Lung 2022; 54:61-67. [PMID: 35349857 DOI: 10.1016/j.hrtlng.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease is a progressive disorder with significant physical, psychological, and social consequences and adversely affects the persons' quality of life (QOL). OBJECTIVES This study aimed to determine the health literacy (HL) and QOL of persons with COPD and some of the contributing factors. METHODS A cross-sectional study was conducted from May to December 2019 on 270 persons with COPD referring to Shahid-Beheshti Hospital of Kashan, Iran. Data were collected using a demographic questionnaire, the 33-item Health Literacy Questionnaire of the Urban Population of Iran (with a total score ranging from 33 to 165, higher score indicates higher HL) and the 50-item St. George's Respiratory Questionnaire for assessing the QOL (with a total score ranging from zero to 100, greater score means lower QOL). Descriptive statistics, Pearson and Spearman correlation coefficient, Chi-square test, t-test, analysis of variance, and linear regression analysis were used to analyze the data. RESULTS The mean age and the mean duration of COPD were 59.48±13.31 and 3.85±3.47 years, respectively. The mean HL score and the mean QOL were 81.44±23.89 and 57.41±10.70, respectively. A significant correlation was found between HL and QOL (r=-0.21, p<0.001). CONCLUSION Participants had moderate levels of HL and QOL. There was a significant correlation between HL and QOL. Health care providers are recommended to take effective steps to improve the HL of persons with COPD by developing comprehensive educational programs for them.
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Affiliation(s)
- Yasaman Raddadi
- Medical Surgical Nursing Department, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, Iran
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12
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O'Sullivan KJ, Power V, Linnane B, McGrath D, Fogarty H, Ryan M, White R, Noonan C, Mulloy E, O'Sullivan LW, Dunne CP. An initial evaluation of the safety of a disposable oscillating positive expiratory pressure device in patients with chronic obstructive pulmonary disease: a sort-term pilot study. BMC Pulm Med 2021; 21:326. [PMID: 34666748 PMCID: PMC8524222 DOI: 10.1186/s12890-021-01689-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Handheld oscillating positive expiratory pressure (OPEP) devices have been a mainstay of treatment for patients with hypersecretory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) since the 1970s. Current devices are reusable and require regular cleaning and disinfection to prevent harbouring potentially pathogenic organisms. Adherence to cleaning regimens for respiratory devices is often poor and in response to this, a prototype disposable OPEP device—the ‘UL-OPEP’ (University of Limerick—Oscillating Positive Expiratory Pressure device)—was developed to mitigate the risk of contamination by pathogens. The device was previously evaluated successfully in a group of paediatric CF patients. The aim of the current study was to initially evaluate the safety of the prototype in patients with COPD over a period of 1 month to ensure no adverse events, negative impacts on lung function, exercise tolerance, or quality of life. Data on user experience of the device were also collected during post-study follow-up. Methods A sample of 50 volunteer participants were recruited from pulmonary rehabilitation clinics within the local hospital network. The patients were clinically stable, productive, and not current or previous users of OPEP devices. Participants were invited to use a prototype disposable OPEP device daily for a period of 1 month. Pre- and post-study lung function was assessed with standard spirometry, and exercise tolerance with the 6-min-walk-test (6MWT). Quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ), and user experience of the prototype device evaluated using a post-study questionnaire. Results 24 Participants completed the study: 9 were female. Overall median age was 67.5 years, range 53–85 years. Lung function, 6-min walk test, and SGRQ scores showed no significant change post-study. User feedback was positive overall. Conclusions The results indicate that the UL-OPEP is safe to use in patients with COPD. No adverse events were recorded during the study or in the follow-up period of 2 weeks. The device did not negatively impact patients’ lung function, exercise tolerance, or quality of life during short term use (1 month), and usability feedback received was generally positive. Larger, longer duration studies will be required to evaluate efficacy. Registration The study was approved as a Clinical Investigation by the Irish Health Products Regulatory Authority (CRN-2209025-CI0085).
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Affiliation(s)
- Kevin J O'Sullivan
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Valerie Power
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Barry Linnane
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.,University Hospital Limerick, Dooradoyle, Limerick, Ireland.,National Children's Research Centre, Crumlin, Dublin 12, Ireland.,Paediatric Cystic Fibrosis Department, University Hospital Limerick (UHL), Limerick, Ireland
| | - Deirdre McGrath
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.,University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Hilda Fogarty
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Rebecca White
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | | | | | - Leonard W O'Sullivan
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Colum P Dunne
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.
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13
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The Upper Extremity Functional Index: Reliability and Validity in Patients with Chronic Obstructive Pulmonary Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010608. [PMID: 34682352 PMCID: PMC8535980 DOI: 10.3390/ijerph182010608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
The aim of the current study was to examine the psychometric properties of the upper extremity functional index (UEFI) in patients with chronic obstructive pulmonary disease (COPD). Seventy patients with stable COPD completed the UEFI and St. George Respiratory Questionnaire (SGRQ) and performed lung function tests in the first testing session. They completed the UEFI and the Global Rating of Change Scale in the second session, which was within ten days of the first session. The UEFI floor and ceiling effects, internal consistency, test–retest reliability, measurement error, and construct validity were examined. The UEFI was found to have no floor and ceiling effects. The UEFI was also found to have an excellent internal consistency (Cronbach’s alpha = 0.955) and an excellent test–retest reliability (ICC2,1 = 0.91). Totals of 4.85 points and 11.32 points represent the scale’s standard error of measurement, and a minimal detectable change at 90% confidence was used. The UEFI scores showed a significant correlation with the SGRQ activity domain (r = −0.66, p < 0.001) and differed significantly between participants with severe disease and those with mild disease (p = 0.03). The UEFI had no floor or ceiling issues, an excellent internal consistency, a good test–retest reliability, and an acceptable measurement error. The UEFI also demonstrated evidence supporting its construct validity as a measure of upper extremity-related activity limitations in patients with COPD.
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D'Urzo AD, Singh D, Donohue JF, Chapman KR, Wise RA. Aclidinium bromide/formoterol fumarate as a treatment for COPD: an update. Expert Rev Respir Med 2021; 15:1093-1106. [PMID: 34137664 DOI: 10.1080/17476348.2021.1920403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Aclidinium/formoterol is a long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) dual bronchodilator used as a maintenance treatment for patients with chronic obstructive pulmonary disease (COPD). The efficacy of aclidinium/formoterol has been demonstrated consistently in patients with moderate-to-severe COPD versus placebo and monocomponents, with a comparable safety profile.Areas covered: This review examines recent research findings that expand our understanding of the impact of aclidinium/formoterol on the burden of COPD. Reviewed outcomes include improvements in lung function, respiratory symptoms, health-related quality of life, exercise tolerance, exacerbation rates, and clinically important deteriorations. In addition, the reported cardiovascular safety of aclidinium and current LAMA/LABA treatment recommendations are discussed.Expert opinion: Aclidinium/formoterol reduces disease burden in patients with COPD, including those that are treatment-naïve, without a significant increase in safety risk compared with monotherapies. Furthermore, evidence supports an improvement in lung function over a 24-hour period with aclidinium/formoterol treatment versus monotherapy and placebo, which may offer an advantage over some once-daily LAMA/LABA combinations. In summary, the recent evidence discussed in this review adds weight to the use of LAMA/LABA combinations as an initial therapy for certain patients newly diagnosed with COPD.
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Affiliation(s)
- Anthony D D'Urzo
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dave Singh
- Medicines Evaluation Unit, Manchester University NHS Foundations Trust, University of Manchester, Manchester, UK
| | - James F Donohue
- Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina Pulmonary Critical Medicine, Chapel Hill, NC, USA
| | - Kenneth R Chapman
- Asthma and Airway Center, University Health Network, Toronto, ON, Canada
| | - Robert A Wise
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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