Prevalence and Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap in Routine Primary Care Practices

Krishnan, Jerry A.; Nibber, Anjan; Chisholm, Alison; Price, David; Bateman, Eric D.; Bjermer, Leif; Boven, Job F M van; Brusselle, Guy; Costello, Richard W.; Dandurand, Ronald; Diamant, Zuzana; Ganse, Éric Van; Gouder, Caroline; Kampen, Sanne van; Kaplan, Alan; Kocks, Janwillem; Miravitlles, Marc; Pizzichini, Emílio; Rhee, Chin Kook; Soriano, Joan B.; Vogelmeier, Claus; Román-Rodríguez, Miguel; Carter, Victoria; D’Urzo, Anthony; Roche, Nicolás

doi:10.1513/annalsats.201809-607oc

Cited by 41 publications

(30 citation statements)

References 23 publications

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“…However, patients with COPD are typically not fully reversible with bronchodilators and some patients likely have both asthma and COPD. 87,90 COPD can present with or without emphysema and depending on the phenotype, and this will affect the appearance of the oscillogram and the resulting parameters. 91 Figure 3 shows an oscillogram and oscillatory parameters of a subject with symptomatic GOLD Stage I, Grade A COPD, with mild airflow limitation and without emphysema as measured by quantitative CT scanning.…”

Section: Copd Without Emphysemamentioning

confidence: 99%

Applications of oscillometry in clinical research and practice

Lundblad

Siddiqui

Bossé

et al. 2019

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

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Oscillometry is gaining in clinical use and while there is an increased interest in the technique, there is paucity in the understanding of its possibilities and limitations. Oscillometry has seen extensive use in research over several decades, but only recently is the technique being adopted in clinical practice; hence, there is a need to educate the novel users. The goal of the mini symposium arranged in San Diego in 2018 was to discuss the principles of oscillometry, showcase some of the recent ongoing research using this technique and to demonstrate how oscillometry may be used in clinical practice. It was concluded that oscillometry has several advantages over spirometry, most notably, with novel data being shown, its sensitivity allowing early detection of small airways disease not possible with spirometry and it can be used in subjects who have difficulties performing forced maneuvers such as preschool children, the elderly and subjects with handicaps. The site of respiratory pathology can be reflected by the various parameters generated by oscillometry and thus help with both disease diagnosis and localization. While the interpretation of oscillometry parameters and translating them into meaningful pathological correlates is still evolving, it is likely that oscillometry will soon be at the forefront of both pulmonary clinical practice and research. R ESUM EL'oscillom etrie est de plus en plus utilis ee en contexte clinique, mais malgr e l'int erêt accru pour cette technique, la compr ehension de ses possibilit es et de ses limites est encore insuffisante. Pendant plusieurs d ecennies, l'oscillom etrie a largement et e utilis ee dans la recherche, mais l'adoption de cette technique dans la pratique clinique est encore r ecente, de sorte qu'il est n ecessaire de former les nouveaux utilisateurs. Le but de ce mini symposium qui s'est tenu a San Diego en 2018 etait de discuter des principes de l'oscillom etrie, de pr esenter les plus r ecentes etudes utilisant cette technique et de d emontrer comment elle peutêtre utilis ee dans la pratique clinique. Il a et e d etermin e que l'oscillom etrie pr esentait plusieurs avantages par rapport a la spirom etrie notamment, comme le d emontrent de nouvelles donn ees, sa sensibilit e qui permet la d etection pr ecoce de la maladie des petites voies a eriennes, ce que la spirom etrie ne peut pas faire, ainsi que le fait qu'elle puisseêtre utilis ee aupr es de sujets qui eprouvent de la difficult e a effectuer des manoeuvres forc ees comme les enfants d'âge pr escolaire, les personnesâg ees et les personnes atteintes d'un handicap. L'emplacement de la pathologie respiratoire peut se refl eter dans les divers param etres produits par la spirom etrie, ce qui peut contribuer a diagnostiquer la maladie et a la localiser. Bien que l'interpr etation des param etres de l'oscillom etrie et leur traduction dans des corr elats pathologiques significatifs continue d' evoluer, l'oscillom etrie sera vraisemblablement a l'avant-plan de la pratique clinique et de la recherche pulmonair...

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Section: Copd Without Emphysemamentioning

confidence: 99%

Applications of oscillometry in clinical research and practice

Lundblad

Siddiqui

Bossé

et al. 2019

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

Self Cite

View full text Add to dashboard Cite

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“…Many studies have reported that patients with ACO are younger than those with only COPD 10,17,30–32. Sex differences have also been reported for ACO, with a higher prevalence among women (4.0%) than in men (2.2%),38 while others found a higher prevalence among men 17,39…”

Section: Discussionmentioning

confidence: 98%

“…ACO has been defined by the Global Initiative for Asthma (GINA) and Global initiative for Obstructive Lung Disease (GOLD) as persistent airflow limitation with several key characteristics typical of both asthma and COPD in the absence of an alternative diagnosis. Epidemiological studies have reported varying prevalence rates for ACO (ranging from 15% to 55%) depending on age, sex and criteria used to define ACO in the sample 10–17. Definitions and diagnostic criteria are yet to be standardised for this relatively new condition.…”

Section: Introductionmentioning

confidence: 99%

<p>Clinical Characteristics Of Patients With Asthma COPD Overlap (ACO) In Australian Primary Care</p>

Izbicki¹,

Teo²,

Liang³

et al. 2019

COPD

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PurposeMany older adults with a history of smoking and asthma develop clinical features of both asthma and COPD, an entity sometimes called asthma-COPD overlap (ACO). Patients with ACO may be at higher risk of poor health outcomes than those with asthma or COPD alone. However, understanding of ACO is limited in the primary care setting and more information is needed to better inform patient management. We aimed to compare the characteristics of patients with ACO or COPD in Australian general practices.Patients and methodsData were from the RADICALS (Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers) trial, an intervention study of an interdisciplinary community-based model of care. Baseline demographic and clinical characteristics, pre- and post-bronchodilator spirometry, dyspnoea and St. George’s Respiratory Questionnaire scores were compared between 60 ACO patients and 212 with COPD alone.ResultsPre-bronchodilator Forced Expiratory Volume in 1 second (mean±SD 58.4±14.3 vs 67.5±20.1% predicted) and Forced Vital Capacity (mean 82.1±16.9 v 91.9±17.2% predicted) were significantly lower in the ACO group (p<0.001), but no difference was found in post-bronchodilator spirometry. Demographic and clinical characteristics, dyspnoea, quality of life, comorbidities and treatment prescribed did not differ significantly between groups.ConclusionThis is the first study describing the clinical characteristics of ACO patients in Australian general practices. Our finding of lower pre-bronchodilator lung function in the ACO group compared to those with COPD reinforces the importance of spirometry in primary care to inform management.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12614001155684.

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“…The small airways in COPD are gradually destroyed leading to chronic bronchitis and emphysema [131]. Optimal pharmacological treatment including rapid treatment of exacerbations, can improve symptoms, reduce exacerbation frequency, and improve exercise tolerance, while poor medication adherence and suboptimal inhaler technique negatively impact outcomes [132]. Adherence to inhaled medication is poor in the real world and shows great variability, ranging from as low as 20% to over 60% [133].…”

Section: Asthma and Copd Managementmentioning

confidence: 99%

Clinical Pharmacists in Chronic Care

Mohiuddin¹

2019

GJMR

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Pharmacy practice has changed significantly lately. The professionals have the chance to contribute straightforwardly to patient consideration so as to lessen morbimortality identified with medication use, promoting wellbeing and preventing diseases. Healthcare organizations worldwide are under substantial pressure from increasing patient demand. Unfortunately, a cure is not always possible particularly in this era of chronic complications, and the role of physicians has become limited to controlling and palliating symptoms.The increasing population of patients with longterm conditions are associated with high levels of morbidity, healthcare costs and GP workloads. Clinical pharmacy took over an aspect of medical care that had been partially abandoned by physicians. Overburdened by patient loads and the explosion of new drugs, physicians turned to pharmacists more and more for drug information, especially within institutional settings. Once relegated to counting and pouring, pharmacists headed institutional reviews of drug utilization and served as consultants to all types of health-care facilities. In addition, when clinical pharmacists are active members of the care team, they enhance proficiency by: Providing critical input on medicine use and dosing. Working with patients to solve problems with their medications and improve compliance.

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Prevalence and Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap in Routine Primary Care Practices

Cited by 41 publications

References 23 publications

Applications of oscillometry in clinical research and practice

Applications of oscillometry in clinical research and practice

<p>Clinical Characteristics Of Patients With Asthma COPD Overlap (ACO) In Australian Primary Care</p>

Clinical Pharmacists in Chronic Care

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