Primary Care Respiratory Journal : Journal of the General Practice Airways Group

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Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief - reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh. Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis...

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BACKGROUND: Guidelines recommend basing asthma management on assessment of asthma control. Validated control tools, while suitable for clinical research, may not be feasible for routine use in primary care. AIMS: To describe the performance of the Pharmacy Asthma Control Screening tool (PACS) compared with the Asthma Control Questionnaire (ACQ-6). METHODS: Data were obtained from a multicentre study of a community pharmacy asthma management programme in Australia, with three or four visits over six months...

BACKGROUND: Severity of airflow obstruction in chronic obstructive pulmonary disease (COPD) is based on forced expiratory volume in one second expressed as percentage predicted (FEV1%predicted) derived from reference equations for spirometry results. AIMS: To establish how switching to new spirometric reference equations would affect severity staging of airflow obstruction in the Dutch primary care COPD patient population. METHODS: Spirometry tests of 3,370 adults aged >40 years with obstruction (postbronchodilator FEV1/forced vital capacity (FVC) <0...

BACKGROUND: The gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD) is spirometry, but there are barriers to its use in primary care. AIMS: To externally validate the COPD Diagnostic Questionnaire (CDQ) as a diagnostic tool in patients at increased risk in Australian general practice and to compare its performance with other CDQ validation studies. METHODS: Patients were recruited from 36 general practices in Sydney, Australia...

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BACKGROUND: Asthma management guidelines advocate a stepwise approach to asthma therapy, including the addition of a long-acting bronchodilator to inhaled steroid therapy at step 3. This is almost exclusively prescribed as inhaled combination therapy. AIMS: To examine whether asthma prescribing practice for inhaled combination therapy (inhaled corticosteroid/long-acting β2-agonist (ICS/LABA)) in primary care in Northern Ireland is in line with national asthma management guidelines...

BACKGROUND: Wheezing phenotypes in young children have usually been described on the basis of questionnaire surveys instead of prospectively doctor-diagnosed episodes, and have never been described in terms of incidence rates. AIMS: To identify wheezing phenotypes in the first three years and describe their incidence trends, and to investigate their relationship with asthma at six years of age. METHODS: Doctor-diagnosed wheezing episodes in the first 36 months and active asthma at six years were identified in a historical cohort of 3,739 children followed from birth in 29 primary care health centres in Spain...

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BACKGROUND: A setting-specific asthma prediction score for preschool children with wheezing and/or dyspnoea presenting in primary healthcare is needed since existing indices are mainly based on general populations. AIMS: To find an optimally informative yet practical set of predictors for the prediction of asthma in preschool children at high risk who present in primary healthcare. METHODS: A total of 771 Dutch preschool children at high risk of asthma were followed prospectively until the age of six years...

BACKGROUND: Studies have suggested that chronic obstructive pulmonary disease (COPD) is commonly misdiagnosed and misclassified in primary care, but less is known about the quality of diagnosis in specialist respiratory care. AIMS: To measure the accuracy of COPD diagnosis and classification of airway obstruction in primary care and at a specialist respiratory centre, and to explore associations between misdiagnosis and misclassification and a range of explanatory factors...

BACKGROUND: Care coordination is defined as good communication between professionals to enable access to services based on need. AIMS: To explore patients' experience of care coordination in order to inform current debates on how best to coordinate care and deliver services in end-of-life for patients with lung cancer and those with chronic obstructive pulmonary disease (COPD). METHODS: A qualitative study involving serial interviews was performed in 18 patients recruited from three hospital outpatient clinics situated in a hospital...