Abstract:Background
Beyond smoking, several risk factors for the development of chronic obstructive pulmonary disease (COPD) have been described, among which socioeconomic status including education is of particular interest. We studied the contribution of education to lung function and symptoms relative to smoking in a group of never-smokers with COPD compared to a group of long-time ex-smokers with COPD.
Methods
We used baseline data of the COSYCONET cohort, including patients… Show more
“…Considering that severe exacerbations are known to have a major impact on the course of the disease, [3,21] it could be argued that in the future COPD patients might benefit from some of the protective measures established during the pandemic., such as a careful selection of contacts and the wearing of face-masks under specific conditions. While a previous analysis of COSYCONET data showed an association between better lung function and higher educational status, [13], the present study found lower levels of adherence to infection control measures among patients with higher education. This should be considered when advising patients on infection control measures.…”
Section: Discussioncontrasting
confidence: 94%
“…[12] Education was categorized in three groups based on the number of years of education completed (basic education ≤9 years, secondary education 10-11 years, higher education >11 years). [13] We used data of the COSYCONET visit 6 for comparison with pre-pandemic measurements. The median time interval between visit 6 and the first COVID survey was 1.6 years.…”
BackgroundInfection control measures for COVID-19 might have affected management and clinical state of patients with chronic obstructive pulmonary disease (COPD). We analysed to which extent this common notion is fact-based.MethodsPatients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2, 3 at 0, 3 and 6 months). The questionnaires comprised behaviour, clinical and functional state and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.ResultsOverall, 594 patients were contacted and 375 patients (58% males, FEV1 61±22%predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with SARS-CoV-2. Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas GOLD D patients were more amenable to tele-consultation.ConclusionIn well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular women and GOLD D patients should be actively contacted by physicians to identify deteriorations.
“…Considering that severe exacerbations are known to have a major impact on the course of the disease, [3,21] it could be argued that in the future COPD patients might benefit from some of the protective measures established during the pandemic., such as a careful selection of contacts and the wearing of face-masks under specific conditions. While a previous analysis of COSYCONET data showed an association between better lung function and higher educational status, [13], the present study found lower levels of adherence to infection control measures among patients with higher education. This should be considered when advising patients on infection control measures.…”
Section: Discussioncontrasting
confidence: 94%
“…[12] Education was categorized in three groups based on the number of years of education completed (basic education ≤9 years, secondary education 10-11 years, higher education >11 years). [13] We used data of the COSYCONET visit 6 for comparison with pre-pandemic measurements. The median time interval between visit 6 and the first COVID survey was 1.6 years.…”
BackgroundInfection control measures for COVID-19 might have affected management and clinical state of patients with chronic obstructive pulmonary disease (COPD). We analysed to which extent this common notion is fact-based.MethodsPatients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2, 3 at 0, 3 and 6 months). The questionnaires comprised behaviour, clinical and functional state and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.ResultsOverall, 594 patients were contacted and 375 patients (58% males, FEV1 61±22%predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with SARS-CoV-2. Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas GOLD D patients were more amenable to tele-consultation.ConclusionIn well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular women and GOLD D patients should be actively contacted by physicians to identify deteriorations.
“…Smoking and age are two most important risk factors of COPD progress (33)(34)(35). Besides, education, annual family income and race are strong social determinants of health status in COPD patients (36)(37)(38).…”
Background and Aims: Little is known about diet-related inflammation in chronic obstructive pulmonary disease (COPD). In this study, we aimed to explore the association between COPD and dietary inflammatory index (DII) scores in adults over 40 years old.Methods: Data were obtained from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES). In the present study, 9,929 participants were included and analyzed. The DII score was calculated and divided into tertiles. Logistic regression analysis was performed to determine the odds ratios of DII tertiles.Results: Participants were categorized into COPD (565, 5.69%) and non-COPD groups (9,364, 94.31%) according to interview information. COPD individuals had higher DII scores than non-COPD individuals (0.429 ± 1.809 vs. −0.191 ± 1.791, p < 0.001). The highest DII score tertile included 46.55% of COPD individuals was associated with lower family incomes and education and a higher smoking rate (p < 0.01). The odds ratios (95% CIs) of COPD according to logistic regression were 0.709 (0.512–0.982) for T1 and 0.645 (0.475–0.877) for T2 of the DII score (p = 0.011).Conclusion: Higher DII scores were positively correlated with COPD in participants over 40 years old. These results further support that diet can be used as an intervention strategy for COPD management.
“… 12 Education level was grouped into three categories based on the number of years of education completed (basic education ≤9 years, secondary education 10 to 11 years, higher education >11 years). 13 Moreover, patients were questioned regarding participation in a disease management program, availability of a treatment plan and whether the treating physician was a pneumologist. Figure 1 Flow-chart diagram of the study population.…”
In many chronic diseases, including COPD, the patients' basic knowledge of the disorder has been shown to be relevant for the course of the disease. We studied which clinical and functional characteristics were related to this knowledge as well as the patients' satisfaction with their knowledge about COPD. Methods: The study population comprised 645 patients of GOLD grades 1-4 who participated in Visit 6 of the COSYCONET cohort (COPD and Systemic Consequences -Comorbidities Network). The assessments covered a broad panel of clinical and functional characteristics, including generic and disease-specific quality of life and the COPD Assessment Test (CAT). The study aim was addressed by two questions, referring to patients' knowledge of the meaning of FEV 1 and the overall satisfaction with their knowledge of COPD. Results: Knowledge of FEV 1 was higher in patients of higher spirometric GOLD grades or exacerbation risk, in males, with higher educational level, and after participation in a prior educational training on COPD. Patients with more detailed knowledge showed a higher satisfaction with their knowledge. Satisfaction was associated with higher generic quality of life and a lower CAT score. Furthermore, satisfaction was higher in patients with a treatment plan but lower in patients with cardiac comorbidities. It appeared that females with basic education, high burden from COPD and low quality of life had the greatest knowledge deficits. Discussion: The results suggest room for education programs adapted to the educational level of the participants. They also emphasize the major role of a disease management plan for the patients.
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