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NPJ Primary Care Respiratory Medicine

Faisal Abuabat, Abdulaziz AlAlwan, Emad Masuadi, Mohammad Hassan Murad, Hamdan Al Jahdali, Mazen Saleh Ferwana
Asthma is a chronic lung disease characterized by airway inflammation and hyper-responsiveness of airway smooth muscles. There is growing evidence that magnesium may have a role in managing asthma through its dual effect as an anti-inflammatory and bronchodilating agent. To assess the efficacy of oral magnesium supplements in chronic asthmatic patients. In addition to searching through and references for oral magnesium supplement studies, we performed a database search in Medline, CINAHL, CENTRAL, and Embase...
February 18, 2019: NPJ Primary Care Respiratory Medicine
Simon Wan Yau Ming, John Haughney, Dermot Ryan, Shishir Patel, Matthias Ochel, Martina Stagno d'Alcontres, Susannah Thornhill, Janwillem W H Kocks, David Price
Co-prescription of Aerochamber® spacer with non-extrafine beclometasone diproprionate (non-EF BDP) is common but unlicensed. We report a comparison of inhaled corticosteroid (ICS)-related adverse events between patients co-prescribed Aerochamber compared to the licensed Volumatic® spacer. We utilised two historical cohorts: questionnaire-based and electronic medical record (EMR)-based, to assess patient-reported and EMR-recorded adverse events in patients with asthma prescribed non-EF BDP. Marginal effect estimate (MEE) was calculated to determine non-inferiority of Aerochamber compared to Volumatic in terms of patient-reported oral thrush and hoarseness with margin of 0...
February 8, 2019: NPJ Primary Care Respiratory Medicine
Stuart Purdie, Nicola Creighton, Kahren Maree White, Deborah Baker, Dan Ewald, Chee Khoon Lee, Alison Lyon, Johnathan Man, David Michail, Alexis Andrew Miller, Lawrence Tan, David Currow, Jane M Young
Little has been published on the diagnostic and referral pathway for lung cancer in Australia. This study set out to quantify general practitioner (GP) and lung specialist attendance and diagnostic imaging in the lead-up to a diagnosis of non-small cell lung cancer (NSCLC) and identify common pathways to diagnosis in New South Wales (NSW), Australia. We used linked health data for participants of the 45 and Up Study (a NSW population-based cohort study) diagnosed with NSCLC between 2006 and 2012. Our main outcome measures were GP and specialist attendances, X-rays and computed tomography (CT) scans of the chest and lung cancer-related hospital admissions...
February 8, 2019: NPJ Primary Care Respiratory Medicine
Shauna McKibben, Andy Bush, Mike Thomas, Chris Griffiths
In the PDF and HTML versions of this Brief Communication a couple of words are not shown in a sentence in the penultimate sentence of the first paragraph of the Results, changing the meaning. This sentence should have been "The setting of a SABA use threshold was likened to "tossing a coin" (Expert 3, primary care)."
January 14, 2019: NPJ Primary Care Respiratory Medicine
Christoph Ulrich Werner, Luisa Koch, Klaus Linde, Levente Kriston, Konrad Schultz, Oxana Atmann, Antonius Schneider
The Control of Allergic Rhinitis and Asthma Test (CARAT10), developed by Portuguese experts, is the only questionnaire assessing asthma control under additional consideration of a frequently concurrent allergic rhinitis (AR), providing sub-scores for both diseases. Aims of this study were the translation and validation of its German version. Asthma patients both with and without AR were included at three primary care pulmologists´ practices in Southern Germany. After translation process, patients completed the CARAT10, the Asthma Control Questionnaire (ACQ), the Asthma Control Test (ACT), and the Standardised Asthma Quality of Life Questionnaire (AQLQ(S))...
December 4, 2018: NPJ Primary Care Respiratory Medicine
K Jolly, M S Sidhu, E Bates, S Majothi, A Sitch, S Bayliss, H J Samuel Kim, R E Jordan
COPD self-management reduces hospital admissions and improves health-related quality of life (HRQoL). However, whilst most patients are managed in primary care, the majority of self-management trials have recruited participants with more severe disease from secondary care. We report the findings of a systematic review of the effectiveness of community-based self-management interventions in primary care patients with COPD. We systematically searched eleven electronic databases and identified 12 eligible randomised controlled trials with seven included in meta-analyses for HRQoL, anxiety and depression...
November 23, 2018: NPJ Primary Care Respiratory Medicine
Janwillem W H Kocks, Henry Chrystyn, Job van der Palen, Mike Thomas, Louisa Yates, Sarah H Landis, Maurice T Driessen, Mugdha Gokhale, Raj Sharma, Mathieu Molimard
Inhaled medications are the cornerstone of treatment and management of asthma and COPD. However, inhaler device errors are common among patients and have been linked with reduced symptom control, an increased risk of exacerbations, and increased healthcare utilisation. These observations have prompted GINA (Global INitiative for Asthma) and GOLD (Global initiative for chronic Obstructive Lung Disease) to recommend regular assessment of inhaler technique in a bid to improve therapeutic outcomes. To better define the relationship between device errors and health outcomes (clinical outcomes, quality of life, and healthcare utilisation) in asthma and COPD, we conducted a systematic review of the literature, with a particular focus on the methods used to assess the relationship between device errors and outcomes...
November 16, 2018: NPJ Primary Care Respiratory Medicine
Nicola McCleary, Amanda Andrews, Audrey Buelo, Mireille Captieux, Susan Morrow, Sharon Wiener-Ogilvie, Monica Fletcher, Liz Steed, Stephanie J C Taylor, Hilary Pinnock
Despite a robust evidence base for its effectiveness, implementation of supported self-management for asthma is suboptimal. Professional education is an implementation strategy with proven effectiveness, though the specific features linked with effectiveness are often unclear. We performed a systematic review of randomised controlled trials and controlled clinical trials (published from 1990 and updated to May 2017 using forward citation searching) to determine the effectiveness of professional education on asthma self-management support and identify features of effective initiatives...
November 6, 2018: NPJ Primary Care Respiratory Medicine
Majid AlTeneiji, Alia AlKalbani, Huda Nasser, Durdana Iram, Afaf Alblooshi, Hassib Narchi
The standard Arabic version of the Childhood Asthma Control Test (C-ACT) has never been previously evaluated in Arab countries. We studied its correlation in Arabic speaking children in the United Arab Emirates (UAE), with both the GINA assessment of asthma control and the resulting changes in asthma management. The Arabic C-ACT was completed by the children or by their parents when needed. A GINA based level of asthma control score was assigned by their managing physician. The correlation between the different cut- scores of the C-ACT and GINA were studied...
November 1, 2018: NPJ Primary Care Respiratory Medicine
Marjolein J C Schot, Anne R J Dekker, Wesley G Giorgi, Rogier M Hopstaken, Niek J de Wit, Theo J M Verheij, Jochen W L Cals
Identifying a child with pneumonia in the large group of children with acute respiratory tract infections can be challenging for primary care physicians. Knowledge on the diagnostic value of specific signs and symptoms may guide future decision rules and guidelines for clinicians. We aimed to identify and systematically review available evidence for the diagnostic value of signs, symptoms, and additional tests to diagnose pneumonia in children in an ambulatory setting in developed countries. We conducted a systematic review, searching in the electronic databases of PubMed and Embase...
October 26, 2018: NPJ Primary Care Respiratory Medicine
Glen Andrews, David K H Lo, Matthew Richardson, Andrew Wilson, Erol A Gaillard
The Royal College of Physicians three questions (RCP3Q) is widely used for assessing asthma control within primary care in the UK, despite limited evidence in children. This study compared the RCP3Q as a tool for assessing asthma control in children (5-16 years) against the validated Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT), and Mini-Paediatric Quality of Life Questionnaire (MiniPAQLQ). We conducted a prospective observational cohort study involving children from eight primary care practices in Leicestershire...
October 24, 2018: NPJ Primary Care Respiratory Medicine
Vicki Hunt, Dave Anderson, Richard Lowrie, Colette Montgomery Sardar, Susan Ballantyne, Graeme Bryson, John Kyle, Peter Hanlon
UK, home-based patients with COPD receive specialist care from respiratory physicians, nurses, and general practitioners (GPs), but increasing complexity of therapeutic options and a GP/Nurse workforce crisis suggests merit in testing the role of home visits by a clinical pharmacist. We conducted a non-randomised intervention study with a contemporaneous comparator group, in Glasgow (Scotland). A clinical pharmacist (working closely with a consultant respiratory physician) visited patients with COPD living at home, assessing respiratory and other co-morbid conditions, and medicines then, with patient approval, agreed treatment modifications with a consultant physician...
October 10, 2018: NPJ Primary Care Respiratory Medicine
Ilja Geraets, Tjard Schermer, Janwillem W H Kocks, Reinier Akkermans, Erik Bischoff, Lisette van den Bemt
To prevent unnecessary use of inhaled corticosteroids (ICS), ICS treatment should only be started when the diagnostic process of asthma and COPD is completed. Little is known about the chronological order between these diagnoses and the start of ICS. We performed a retrospective cohort study, based on electronic medical records of 178 Dutch general practices, to explore the temporal relations between starting continuous use of ICS and receiving a diagnosis of asthma and/or COPD. The database included information of patients who were registered with a diagnosis of asthma and/or COPD in one of the practices during January 1, 2012 and December 31, 2013...
October 9, 2018: NPJ Primary Care Respiratory Medicine
Miriam Barrecheguren, Mónica Monteagudo, Marc Miravitlles
This epidemiological study aimed to describe and compare the characteristics and outcomes of COPD patients starting treatment with a long-acting anti-muscarinic (LAMA) or a combination of a long-acting beta-2 agonist (LABA)/LAMA in primary care in Catalonia (Spain) over a one-year period. Data were obtained from the Information System for the Development in Research in Primary Care (SIDIAP), a population database containing information of 5.8 million inhabitants (80% of the population of Catalonia). Patients initiating treatment with a LAMA or LABA/LAMA in 2015 were identified, and information about demographic and clinical characteristics was collected...
September 28, 2018: NPJ Primary Care Respiratory Medicine
Jieqiong Freda Yang, Rekha Chaudhuri, Neil C Thomson, Nitish Ramparsad, Hugh O'Pray, Stephen Barclay, Sean MacBride-Stewart, Craig McCallum, Varun Sharma, Charles McSharry, Dianne Murray, Malcolm Shepherd, Wai-Ting Nicola Lee
The United Kingdom National Review of Asthma Deaths (NRAD) recommends that patients who require ≥3 courses of oral corticosteroids (OCS) for exacerbations in the past year or those on British Thoracic Society (BTS) Step 4/5 treatment must be referred to a specialist asthma service. The aim of the study was to identify the proportion of asthma patients in primary care that fulfil NRAD criteria for specialist referral and factors associated with frequent exacerbations. A total of 2639 adult asthma patients from 10 primary care practices in Glasgow, UK were retrospectively studied between 2014 and 2015...
September 19, 2018: NPJ Primary Care Respiratory Medicine
Biljana Cvetkovski, Rachel Tan, Vicky Kritikos, Kwok Yan, Elizabeth Azzi, Pamela Srour, Sinthia Bosnic-Anticevich
Allergic rhinitis (AR) is increasingly becoming a patient self-managed disease. Just under 70% of patients purchasing pharmacotherapy self-select their treatment with no health-care professional intervention often resulting in poor choices, leading to suboptimal management and increased burden of AR on the individual and the community. However, no decision is made without external, influencing forces. This study aims to determine the key influences driving patients' decision-making around AR management. To accomplish this aim, we utilised a social network theory framework to map the patient's AR network and identify the strength of the influences within this network...
September 13, 2018: NPJ Primary Care Respiratory Medicine
Björn Ställberg, Christer Janson, Kjell Larsson, Gunnar Johansson, Konstantinos Kostikas, Jean-Bernard Gruenberger, Florian S Gutzwiller, Leif Jorgensen, Milica Uhde, Karin Lisspers
This study aimed to generate real-world evidence to assess the burden of comorbidities in COPD patients, to effectively manage these patients and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients using electronic medical record data collected between 2000 and 2014. These patients were studied for prevalence of various comorbidities and for association of these comorbidities with exacerbations, mortality, and healthcare costs compared with an age-, sex-, and comorbidities-matched non-COPD reference population...
September 10, 2018: NPJ Primary Care Respiratory Medicine
MeiLan K Han, Riju Ray, Jason Foo, Chaienna Morel, Beth Hahn
Dual bronchodilator maintenance therapy may benefit patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) versus long-acting muscarinic antagonist (LAMA) monotherapy. The efficacy and safety of US-approved LAMA/long-acting beta-agonist (LABA) combinations versus tiotropium (TIO), a LAMA, were assessed. This systematic review and meta-analysis (GSK: 206938), conducted in MEDLINE, MEDLINE In-process, and EMBASE following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, identified randomized clinical trials (>8 weeks) in moderate-to-severe COPD (per Global Initiative for Chronic Obstructive Lung Disease guidelines), receiving LAMA/LABA or TIO...
August 27, 2018: NPJ Primary Care Respiratory Medicine
Bhumika Aggarwal, Aruni Mulgirigama, Norbert Berend
Exercise-induced bronchoconstriction (EIB) can occur in individuals with and without asthma, and is prevalent among athletes of all levels. In patients with asthma, symptoms of EIB significantly increase the proportion reporting feelings of fearfulness, frustration, isolation, depression and embarrassment compared with those without symptoms. EIB can also prevent patients with asthma from participating in exercise and negatively impact their quality of life. Diagnosis of EIB is based on symptoms and spirometry or bronchial provocation tests; owing to low awareness of EIB and lack of simple, standardised diagnostic methods, under-diagnosis and mis-diagnosis of EIB are common...
August 14, 2018: NPJ Primary Care Respiratory Medicine
Frits M E Franssen, Dionne E Smid, Dorly J H Deeg, Martijn Huisman, Jan Poppelaars, Emiel F M Wouters, Martijn A Spruit
Chronic obstructive pulmonary disease (COPD) is associated with substantial health impact that may already become apparent in early disease. This study aims to examine the features of subjects with COPD in a Dutch population-based sample and compare their physical status, mental status, and social status to non-COPD subjects. This study made use of Longitudinal Aging Study Amsterdam (LASA) data. Demographics, clinical characteristics, self-reported diseases, post-bronchodilator spirometry, physical, mental, and social status were assessed...
August 10, 2018: NPJ Primary Care Respiratory Medicine
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