Effectiveness of home versus hospital care in the routine treatment of cystic fibrosis

Bosworth, Darin G.; Nielson, Dennis W.

doi:10.1002/(sici)1099-0496(199707)24:1<42::aid-ppul7>3.0.co;2-l

Cited by 61 publications

(41 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, longterm costs may not be reduced in the outpatient setting because of the need for longer and more frequent courses of antibiotics (9), and quality of life may not be better across all domains (7,10). Additionally, several studies have documented no difference between inpatient and outpatient therapy in terms of compliance with antibiotic therapy (5) or improvement in FEV 1 (4)(5)(6)(7)(10)(11)(12)(13).…”

mentioning

confidence: 99%

“…Additionally, several studies have documented no difference between inpatient and outpatient therapy in terms of compliance with antibiotic therapy (5) or improvement in FEV 1 (4)(5)(6)(7)(10)(11)(12)(13). Conversely, other studies have shown a significantly greater improvement in FEV 1 after inpatient treatment compared with outpatient treatment (9,(14)(15)(16)(17). It is important to recognize that most studies have consisted of fewer than 100 patients in a few clinical sites, which may have resulted in limited power and clinic-specific biases.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Location and Duration of Treatment of Cystic Fibrosis Respiratory Exacerbations Do Not Affect Outcomes

Collaco¹,

Green²,

Cutting³

et al. 2010

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Individuals with cystic fibrosis (CF) are subject to recurrent respiratory infections (exacerbations) that often require intravenous antibiotic treatment and may result in permanent loss of lung function. The optimal means of delivering therapy remains unclear. Objectives: To determine whether duration or venue of intravenous antibiotic administration affect lung function. Conclusions: Intravenous antibiotic therapy for CF respiratory exacerbations administered in the hospital and in the home was found to be equivalent in terms of long-term FEV 1 change and interval between courses of antibiotics. Optimal duration of therapy (7-10 d) may be shorter than current practice. Large prospective studies are needed to answer these essential questions for CF respiratory management.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Location and Duration of Treatment of Cystic Fibrosis Respiratory Exacerbations Do Not Affect Outcomes

Collaco¹,

Green²,

Cutting³

et al. 2010

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…A correlação PaO 2 versus P-O VEF 1 /CVF mostra um índice de correlação regular 6 inverso (r = -0,54), evidenciando que a gasometria arterial e a espirometria vêm a ser dois exames laboratoriais independentes ao avaliarem componentes diferentes da função pulmonar: o primeiro, a hematose e a ventilação alveolar; e o segundo, a ventilação total. Analisando-se a literatura [15][16][17][18] , observa-se, contraditoriamente, que o estudo da função pulmonar em pacientes com fibrose cística centra-se muito mais na análise de valores obtidos na espirometria, uma vez que o fluxo expiratório forçado 25-75 (o fluxo médio de ar expirado durante a metade central da capacidade vital forçada, medido em litros por segundo) e, principalmente, a relação volume expiratório forçado no primeiro segundo sobre a capacidade vital forçada (relação do volume de ar expirado durante o primeiro segundo de um esforço expiratório máximo e realizado de maneira rápida sobre a diferença de volume de ar entre a inspiração e a expiração completas, medida ao nível da boca, quando realizada com esforço expiratório máximo e de maneira rápida) tornaram-se parâ-metros consagrados para avaliação da função pulmonar destes pacientes 14. Conclui-se que a totalidade dos indivíduos avaliados com fibrose cística está com algum grau de acometimento pulmonar, pelo menos com colonização crônica (maior que 1 ano) da árvore brônquica por agentes como a Pseudomonas aeruginosa e/ou Staphylococcus aureus. A gasometria arterial detectou maior número de pacientes com alteração na função pulmonar do que a espirometria, porém os dois exames complementam-se para uma boa avaliação funcional pulmonar dos pacientes estudados.…”

Section: Discussionunclassified

Study of lung involvement in patients with cystic fibrosis

Dornelas¹,

Fernandes²,

Galvão³

et al. 2000

J Pediatr (Rio J)

View full text Add to dashboard Cite

Objective: To characterize the involvement of the respiratory apparatus of patients with cystic fibrosis in order to obtain a comprehensive view of their pulmonary picture.Methods: Data were obtained retrospectively from the medical records of 16 patients with cystic fibrosis; arterial gas and spirometry data were obtained prospectively for the same patients, who were not in an acute pulmonary situation. The patients were subjects of both sexes aged 6 years or older who were followed up at the Pediatrics Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, USP.Results: Median patient age was 114 months (9 years and 6 months) ranging between 72 -360 months, and 68.75% were males. Productive cough was the most frequent symptom observed in 75% of the population studied. All patients had positive sputum culture obtained at least one year before, with Pseudomonas aeruginosa being detected in 81.25% of the cases. Arterial gases revealed some abnormalities in 81.25% of the patients and spirometry revealed abnormalities in 56.25%.Conclusion: All patients presented at least one type of pulmonary alteration. Measurement of arterial gases detected a larger number of patients with altered pulmonary function than did spirometry, but the two examinations complemented each other for a good evaluation of pulmonary function.J. pediatr. (Rio J.). 2000; 76(4): 295-299: cystic fibrosis, pulmonary function, arterial gas, spirometry. ResumoObjetivo: O trabalho teve por finalidade caracterizar o acometimento do aparelho respiratório de pacientes com fibrose cística a fim de termos um panorama do quadro pulmonar dos mesmos.Métodos: Avaliação de dados obtidos, retrospectivamente, de prontuários médicos e de resultados prospectivos de gasometria arterial e espirometria de 16 pacientes com fibrose cística fora do quadro de doença pulmonar agudizada, com idade maior ou igual a 6 anos, de ambos os sexos, seguidos no ambulatório de Pediatria do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto -USP-.Resultados: A mediana de idade dos pacientes foi de 114 meses (9 anos e 6 meses) com variação de 72 -360 meses. 68,75% são do sexo masculino. A tosse produtiva foi o sintoma mais freqüente (75% da população estudada). 100% dos indivíduos possuem cultura de escarro positiva de longa data (pelo menos 1 ano), sendo 81,25% por Pseudomonas aeruginosa. A gasometria arterial revelou alguma anormalidade em 81,25% dos indivíduos e a espirometria em 56,25% dos indivíduos.Conclusão: Todos os pacientes analisados apresentam pelo menos um tipo de alteração pulmonar. A gasometria arterial detectou maior número de pacientes com alteração na função pulmonar do que a espirometria, porém os dois exames complementam-se para uma boa avaliação funcional pulmonar.

show abstract

“…An appropriate policy response might be to ensure that mechanisms are put in place to facilitate equitable delivery of treatments at home, wherever possible. Home care has been shown to be as effective as hospital treatment for some patients (van Aalderen et al 1995), but not others (Bosworth and Nielson 1997;Thornton et al 2005). It is also less expensive and may be associated with improvement in quality of life (van Aalderen et al 1995).…”

Section: What Are the Implications For Policy And Clinicians?mentioning

confidence: 99%

Health Trajectories in People with Cystic Fibrosis in the UK: Exploring the Effect of Social Deprivation

Taylor‐Robinson

Diggle

Smyth³

et al. 2015

A Life Course Perspective on Health Trajectories and Transitions

View full text Add to dashboard Cite

Exploring the reasons for inequalities in outcomes in people with cystic fibrosis (CF) offers a unique opportunity to develop our understanding around pathways in inequalities in health more generally. Because CF is genetically determined, a socio-economic difference in incidence is not expected, but there may be important differences in outcomes over the course of people's lives.Studies across the world have consistently shown that people from socioeconomically disadvantaged backgrounds experience worse health than those in more socio-economically advantaged positions. These inequalities in health outcomes are preventable, amenable to policy intervention, and they are unjust. In the UK and internationally, policies are being implemented to try to reduce health inequalities, with limited success, since for many important health outcomes, such as life expectancy in the UK, despite continuing overall improvements, significant inequalities remain (Marmot et al. 2010;Barr et al. 2012). In order to develop more effective interventions, we need a better understanding of how, and when, these health differences are generated and maintained.This chapter brings together findings from our previously published longitudinal registry studies examining the effect of social deprivation on longitudinal clinical outcomes, healthcare use and employment opportunities in people with cystic

show abstract

Effectiveness of home versus hospital care in the routine treatment of cystic fibrosis

Cited by 61 publications

References 9 publications

Location and Duration of Treatment of Cystic Fibrosis Respiratory Exacerbations Do Not Affect Outcomes

Location and Duration of Treatment of Cystic Fibrosis Respiratory Exacerbations Do Not Affect Outcomes

Study of lung involvement in patients with cystic fibrosis

Health Trajectories in People with Cystic Fibrosis in the UK: Exploring the Effect of Social Deprivation

Contact Info

Product

Resources

About