Impact of COPD Exacerbations and Burden of Disease in Spain: AVOIDEX Study

Soler-Cataluña, Juan José; Izquierdo, José Luis; Campo, M Juarez; Sicras‐Mainar, Antoni; Nuevo, Javier

doi:10.2147/copd.s406007

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…In UMICs, clinicians reported that over 50% of COPD diagnoses are made following an exacerbation. In contrast, this was substantially lower in HICs (10-20%), which is consistent with other literature on exacerbations (30,31). These perspectives suggest that in UMICs, there might be an even greater delay in recognising and diagnosing COPD, which could impact timely intervention and disease management.…”

Section: Discussionsupporting

confidence: 92%

Mapping the common barriers to optimal COPD care in high and middle-income countries: qualitative perspectives from clinicians

Shahaj,

Meiwald,

Sudhir

et al. 2023

Preprint

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BackgroundAlthough predominantly preventable and treatable, chronic obstructive pulmonary disease (COPD) is a leading cause of death globally. Guidelines for managing the condition are widely available, yet COPD care remains suboptimal in many settings, including high and middle-income countries (HICs and MICs). Several approaches are used to diagnose and manage COPD, resulting in substantial variation in its care pathways. This study aimed to explore how barriers to optimal COPD care vary across HICs and MICs by identifying common and unique barriers to COPD care in six countries to inform global policy initiatives for better care while addressing specific challenges.MethodsBased on international and national guidelines, we mapped COPD care pathways for Australia, Spain, Taiwan, Argentina, Mexico, and Russia. Country-specific pathways were populated with published epidemiological, health economic, and clinical data identified through a pragmatic literature review. Semi-structured interviews with 17 respiratory care clinicians further informed and validated the pathways, data inputs, and key issues arising in each country. Thematic content analysis was used to analyse common and unique barriers across countries.ResultsSix themes were common in most HICs and MICs:“Challenges in COPD diagnosis”, “Strengthening the role of primary care”, “Fragmented healthcare systems and coordination challenges”, “Inadequate management of COPD exacerbations”; “Limited access to specialised care” and, “Impact of underfinanced and overloaded healthcare systems”. One theme,“Insurance coverage and reimbursement challenges”, was more relevant for MICs.HICs and MICs differ in patient and healthcare provider awareness, primary care involvement, spirometry access, and specialised care availability. Both face issues with healthcare fragmentation, guideline adherence, and COPD exacerbation management. MICs also grapple with resource limitations and healthcare infrastructure challenges.ConclusionMany challenges to COPD care are the same in both HICs and MICs, underscoring the pervasive nature of these issues. While country-specific issues require customised solutions, there are untapped possibilities for implementing global respiratory strategies that motivate countries to manage COPD effectively. In addition to healthcare system-level initiatives, there is a crucial need for political prioritisation of COPD to secure the essential resources it requires.

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Section: Discussionsupporting

confidence: 92%

Mapping the common barriers to optimal COPD care in high and middle-income countries: qualitative perspectives from clinicians

Shahaj,

Meiwald,

Sudhir

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In contrast, this was substantially lower in HICs (10–20%), consistent with other literature on exacerbations. 33 , 34 These perspectives suggest that in UMICs, there might be an even greater delay in recognizing and diagnosing COPD, which could impact timely intervention and disease management.…”

Section: Discussionmentioning

confidence: 99%

Mapping the Common Barriers to Optimal COPD Care in High and Middle-Income Countries: Qualitative Perspectives from Clinicians

Shahaj,

Meiwald,

Puri Sudhir

et al. 2024

COPD

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Purpose Chronic obstructive pulmonary disease (COPD) poses a significant global health burden despite being largely preventable and treatable. Despite the availability of guidelines, COPD care remains suboptimal in many settings, including high-income countries (HICs) and upper-middle-income countries (UMICs), with varied approaches to diagnosis and management. This study aimed to identify common and unique barriers to COPD care across six countries (Australia, Spain, Taiwan, Argentina, Mexico, and Russia) to inform global policy initiatives for improved care. Methods COPD care pathways were mapped for each country and supplemented with epidemiological, health-economic, and clinical data from a targeted literature review. Semi-structured interviews with 17 respiratory care clinicians were used to further validate the pathways and identify key barriers. Thematic content analysis was used to generate the themes. Results Six themes were common in most HICs and UMICs: “Challenges in COPD diagnosis”, “Strengthening the role of primary care”, “Fragmented healthcare systems and coordination challenges”, “Inadequate management of COPD exacerbations”, “Limited access to specialized care” and, “Impact of underfinanced and overloaded healthcare systems”. One theme, “Insurance coverage and reimbursement challenges”, was more relevant for UMICs. HICs and UMICs differ in patient and healthcare provider awareness, primary care involvement, spirometry access, and availability of specialized care. Both face issues with healthcare fragmentation, guideline adherence, and COPD exacerbation management. In addition, UMICs also grapple with resource limitations and healthcare infrastructure challenges. Conclusion Many challenges to COPD care are the same in both HICs and UMICs, underscoring the pervasive nature of these issues. While country-specific issues require customized solutions, there are untapped possibilities for implementing global respiratory strategies that support countries to manage COPD effectively. In addition to healthcare system-level initiatives, there is a crucial need for political prioritization of COPD to allocate the essential resources it requires.

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“…It is mainly related to the abnormal inflammation of the lungs caused by harmful gases and particles ( 1 ). COPD is projected to become the third leading cause of death worldwide by 2030 ( 2 ). Additionally, it is the fourth leading cause of death in China, with its prevalence increasing every year ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Developing and validating machine learning-based prediction models for frailty occurrence in those with chronic obstructive pulmonary disease

Chen,

Yu,

Yang

et al. 2024

J Thorac Dis

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Background Frailty is a medical syndrome caused by multiple factors, characterized by decreased strength, endurance, and diminished physiological function, resulting in increased susceptibility to dependence and/or death. Patients with chronic obstructive pulmonary disease (COPD) tend to be more vulnerable to frailty due to their physical and psychological burdens. Therefore, the aim of this study was to develop a reliable and accurate vulnerability risk prediction model for frailty in patients with COPD in order to improve the identification and prediction of patient frailty. The specific objectives of this study were to determine the prevalence of frailty in patients with COPD and develop a prediction model and evaluate its predictive power. Methods Clinical information was analyzed using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, and 34 indicators, including behavioral factors, health status, mental health parameters, and various sociodemographic variables, were examined in the study. The adaptive synthetic sampling technique was used for unbalanced data. Three methods, ridge regressor, extreme gradient boosting (XGBoost) classifier, and random forest (RF) regressor, were used to filter predictors. Seven machine learning (ML) techniques including logistic regression (LR), support vector machines (SVM), multilayer perceptron, light gradient-boosting machine, XGBoost, RF, and K-nearest neighbors were used to analyze and determine the optimal model. For customized risk assessment, an online predictive risk modeling website was created, along with Shapley additive explanation (SHAP) interpretations. Results Depression, smoking, gender, social activities, dyslipidemia, asthma, and residence type (urban vs. rural) were predictors for the development of frailty in patients with COPD. In the test set, the XGBoost model had an area under the curve of 0.942 (95% confidence interval: 0.925–0.959), an accuracy of 0.915, a sensitivity of 0.873, and a specificity of 0.911, indicating that it was the best model. Conclusions The ML predictive model developed in this study is a useful and easy-to-use instrument for assessing the vulnerability risk of patients with COPD and may aid clinical physicians in screening high-risk patients.

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Impact of COPD Exacerbations and Burden of Disease in Spain: AVOIDEX Study

Cited by 4 publications

References 28 publications

Mapping the common barriers to optimal COPD care in high and middle-income countries: qualitative perspectives from clinicians

Mapping the common barriers to optimal COPD care in high and middle-income countries: qualitative perspectives from clinicians

Mapping the Common Barriers to Optimal COPD Care in High and Middle-Income Countries: Qualitative Perspectives from Clinicians

Developing and validating machine learning-based prediction models for frailty occurrence in those with chronic obstructive pulmonary disease

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