&lt;p&gt;Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects&lt;/p&gt;

Garg, Himanshu; Er, Xin Y.; Howarth, Timothy; Heraganahally, Subash S.

doi:10.2147/nss.s286403

Cited by 15 publications

(15 citation statements)

References 59 publications

(93 reference statements)

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“…Indigenous people have a higher burden of chronic health conditions, including cardiorespiratory disorders, giving rise to higher morbidity and mortality [33][34][35][36][37]. Understanding the different clinical manifestations [38][39][40] and appropriate interventions [41][42][43][44][45][46][47][48][49][50] will help in early diagnosis and management of chronic health conditions in the Indigenous population, for better health related outcomes. Varying manifestations of sex differences in PFTP's have been demonstrated in this study, both with and without underlying radiological evidence of CADs among an Indigenous Australian cohort.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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Background Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse. Methods PFTPs were compared between male and female Indigenous Australian adults with and without chest radiologically proven chronic airway diseases (CADs). Results 485 adults (56% were female) with no significant difference in age, body mass index or smoking status between sexes were included. Females displayed a higher prevalence of radiology without CADs compared to males (66 vs. 52%, respectively). Among patients without CADs, after adjustment for age, stature and smoking, males displayed significantly higher absolute values of Forced Vital Capacity (FVC) (mean difference, 0.41L (0.21,0.62), p<0.001) and Forced Expiratory Volume in one second (FEV1) (mean difference 0.27L (0.07,0.47), p<0.001), with no significant difference in FEV1/FVC ratio (mean difference -0.02 (-0.06, 0.02), p = 0.174). Male and female patients with radiologically proven CADs demonstrated lower FEV1/FVC values. However, compared to females, males showed significantly greater reductions in pre- [-0.53 (-0.74, -0.32) vs. -0.29 (-0.42, -0.16), p = 0.045] and post- [-0.51 (-0.72, -0.3) vs. -0.27 (-0.39, -0.14), p = 0.049] bronchodilator FEV1. Conclusions There are significant sex differences in the PFTPs among Indigenous Australians. Recognising these differences may be of value in the accurate diagnosis, management, monitoring and prognostication of CADs in this population.

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Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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“…As such, it is plausible that the current study captured anywhere from 40% to 60% of current Indigenous COPD patients in the TEHS region. More recently, several aspects of respiratory health issues among Indigenous Australians from the TEHS region of the NT has been reported in the literature 19–24 28 32 35–40 52–66. Hence, this study could be considered as an important further step forward67 in addressing COPD disease awareness and knowledge in an Indigenous population.…”

Section: Discussionmentioning

confidence: 76%

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

et al. 2022

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BackgroundThe prevalence of chronic obstructive pulmonary disease (COPD) is higher among Indigenous Australians than that of non-Indigenous Australians. However, no studies have investigated COPD disease awareness and knowledge among Indigenous Australians. In this study, we assessed the COPD disease awareness among Indigenous and non-Indigenous patients in the Top End Health Service region of the Northern Territory of Australia.MethodsOf a total convenience sample of 100 adults, 86 patients consented to participate in this study over a 15-month period. A structured interview was conducted to identify participant’s level of knowledge about COPD, medications, self-management, healthcare interaction and utilisations.ResultsMost (69%) participants were Indigenous and men (52%). Indigenous patients were significantly younger (mean 56 vs 68 years p<0.001), with a higher proportion of remote residence and current smoking. COPD knowledge across the cohort was low, with 68% of Indigenous and 19% of non-Indigenous participants reporting they ‘know nothing/had never heard of COPD’. Most patients self-reported use of puffers/inhalers and were able to identify medication used; however, adherence to therapy was observed in only 18%. Shortness of breath was the most common symptom for hospital presentation (83%) and 69% of Indigenous patients reported seeking medical attention during an exacerbation. Self-management and COPD action plans were poorly implemented. A significant proportion (49%) reported ≥2 hospital admissions in the preceding 12 months. During exacerbation, although the majority of Indigenous patients were transferred to a tertiary centre from remote communities, patient’s preference was to be managed in their respective local communities.ConclusionsAwareness and understanding of COPD are low in this cohort on several domains. Tailored and culturally appropriate initiatives for both patients and health professionals alike are required to improve COPD disease management among Indigenous population. This will not only improve quality of life but also reduce recurrent hospitalisation, healthcare cost and utilisation.

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“…However, excessive yearly decline in FEV 1 is noted to be higher among patients using ICS containing pharmacotherapy alongside higher all-cause mortality in comparison to patients with non-ICS containing inhaled pharmacotherapy or no pharmacotherapy. In the light of this study, and the authors several years of experience in managing Indigenous patients with chronic health conditions, [7][8][9][10][11][12][13][14][15][16]54,[65][66][67][68][69][70][71][72] until and unless further prospective large scale studies are available to prove or disprove if ICS pharmacotherapy is a friend or foe in the management among Indigenous people, we sincerely recommend and advocate extreme caution in utilising…”

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confidence: 90%

The Effects of Inhaled Airway Directed Pharmacotherapy on Decline in Lung Function Parameters Among Indigenous Australian Adults With and Without Underlying Airway Disease

Heraganahally¹,

Ponneri²,

Howarth³

et al. 2021

COPD

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Background The trajectory of lung function decline among Indigenous patients with or without underlying chronic airway disease (COPD and concomitant bronchiectasis) and with use of inhaled pharmacotherapy, including inhaled corticosteroids (ICS), has not been reported in the past. Methods Adult Indigenous Australian patients identified to have undergone at least two or more lung function tests (LFTs) between 2012 and 2020 were assessed for changes in the lung function parameters (LFPs) between the first and last recorded LFTs. Results Of the total 1350 patients identified to have undergone LFTs, 965 were assessed to fulfil session quality, 115 (n=58 females) were eligible to be included with two or more LFTs. Among the 115 patients, 49% showed radiological evidence of airway diseases, and 77% were on airway directed inhaled pharmacotherapy. Median time between LFTs was 1.5 years (IQR 0.86,5.85), with no significant differences in LFPs noted between first and last LFT. Overall rate of change (mL/year) showed considerable variation for FVC (median −37.55 mL/year [IQR −159.88,92.67]) and FEV 1 (−18.74 mL/year [−102.49,71.44]) with minimal change in FEV 1 /FVC (0.00 ratio/year [−0.03,0.01]). When stratified by inhaled pharmacotherapy group, however, patients using ICS showed significantly greater rate of FEV 1 decline (−48.64 mL/year [−110.18,62.5]) compared to those using pharmacotherapy with no ICS (15.46 mL/year [−73.5,74.62]) and those using no pharmacotherapy (−5.76 mL/year [−63.19,67.34]) (p=0.022). Additionally, a greater proportion of these patients reached the threshold for excessive FEV 1 decline (64%) compared to those using pharmacotherapy without ICS (44%) and those using no pharmacotherapy (52%). Conclusion Decline in LFPs occurs commonly among adult Indigenous population, especially, excessive so among those using inhaled pharmacotherapy containing ICS.

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<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Cited by 15 publications

References 59 publications

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

The Effects of Inhaled Airway Directed Pharmacotherapy on Decline in Lung Function Parameters Among Indigenous Australian Adults With and Without Underlying Airway Disease

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