Prioritising primary care respiratory research needs: results from the 2020 International Primary Care Respiratory Group (IPCRG) global e-Delphi exercise

Abdel-Aal, Arwa; Lisspers, Karin; Williams, Siân; Adab, Peymané; Adams, Rachel; Aggarwal, Dhiraj; Barnard, Amanda; Bouloukaki, Izolde; Boven, Job F M van; Chavannes, Niels H.; Dickens, Andrew; Gemert, Frederik van; Escarrer, Mercedes; Haroon, Shamil; Kayongo, Alex; Kirenga, Bruce; Kocks, Janwillem; Kotz, Daniel; Newby, Chris; McNulty, C.; Metting, Esther; Moral, Luis; Papadakis, Sophia; Pinnock, Hilary; Price, David; Singh, Sally; Sousa, Jaime Correia de; Ställberg, Björn; Szefler, Stanley J.; Taylor, Stephanie J C; Tsiligianni, Ioanna; Turner, Alice; Weller, David; Yusuf, Osman; Tabyshova, Aizhamal; Jordan, Rachel

doi:10.1038/s41533-021-00266-4

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…This is in line with previous results from Greenland, where 13% of all consultations where related to the respiratory system [ 13 ]. Moreover, a recent international questionnaire study states respiratory diseases as a significant source of morbidity and mortality in PHC [ 17 ]. Further contributing to the high frequency of respiratory health problems among the Greenlandic population is smoking.…”

Section: Discussionmentioning

confidence: 99%

Patterns in contacts with primary health care centres in Greenland

Botvid

Hove

Mikkelsen

et al. 2023

International Journal of Circumpolar Health

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The aim of this study was to evaluate the activity within the primary health care (PHC) in Greenland by identifying the patterns of all registered contacts made by patients in 2021, and to compare the most frequently used types of contacts and diagnostic codes in Nuuk to the rest of Greenland. The study was designed as a cross-sectional register study using data from the national electronic medical records (EMR) and diagnostic codes from the ICPC-2-system. In 2021, 83.7% (46,522) of the Greenlandic population were in contact with the PHC, resulting in 335,494 registered contacts. The majority of the contacts with PHC was made by females (61.3%). On average, females were in contact with PHC 8.4 times per patient per year, while males were in contact with PHC 5.9 times per patient per year. The most frequently used diagnostic group was “General and unspecified”, followed by “Musculoskeletal” and “Skin”. The results are in line with studies from other northern countries and indicate an easily accessible PHC system, with a predominance of female contacts.

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Section: Discussionmentioning

confidence: 99%

Patterns in contacts with primary health care centres in Greenland

Botvid

Hove

Mikkelsen

et al. 2023

International Journal of Circumpolar Health

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“…Adherence to the inhalers was assessed with the 12-item Test of Adherence to Inhalers 11 . Items 1 to 10 were answered by the patients and scored on a 5-point Likert scale (1)(2)(3)(4)(5). Item 11 was answered by the HCP performing the study visit.…”

Section: Medication Adherencementioning

confidence: 99%

“…This study found that suboptimal peak inspiratory flow (sPIF) and inhalation technique errors were associated with poor health status in COPD patients, whereas DPI adherence was not associated to poor health status 2 . According to the most recent International Primary Care Respiratory Group research prioritisation exercise 3 , significant evidence gaps remain within the study of respiratory diseases, coinciding with a lack of evidence-based guidelines, quality standards and training to support primary care for patients with respiratory diseases, such as COPD. Drawing on the views of primary healthcare professionals (HCPs) worldwide, there is a need for more effective clinical education in order to deliver best-practice primary care.…”

Section: Introductionmentioning

confidence: 99%

Clinical recommendations for dry powder inhaler use in the management of COPD in primary care

Leving

Bosnic‐Anticevich

Cooten

et al. 2022

npj Prim. Care Respir. Med.

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Over 1400 patients using dry powder inhalers (DPIs) to deliver COPD maintenance therapies were recruited across Europe and Australia. Their peak inspiratory flow (PIF) was measured, inhaler technique was observed, and adherence to treatment assessed. From relating the findings with patient health status, and thereby identifying critical errors, key clinical recommendations for primary care clinicians were determined, namely – measure PIF before prescribing a DPI to ensure inhalation manoeuvre ability is well-matched with the device. Some patients could benefit from inhalation training whereas others should have their DPI changed for one better suited to their inspiratory ability or alternatively be prescribed an active device (such as a soft mist inhaler or pressurized metered dose inhaler). Observing the inhalation technique was valuable however this misses suboptimal PIF (approaching one fourth of patients with a satisfactory observed manoeuvre had a suboptimal PIF for their DPI). Assess adherence as deliberate non-adherence can point to a mismatch between a patient and their inhaler (deliberate non-adherence was significantly associated with PIFs below the minimum for the DPI). In-person observation of inhalation technique was found to be inferior to video rating based on device-specific checklists. Where video assessments are not possible, observation training for healthcare professionals would therefore be valuable particularly to improve the ability to identify the critical errors associated with health status namely ‘teeth and lips sealed around mouthpiece’, ‘breathe in’ and ‘breathing out calmly after inhalation’. However, it is recommended that observation alone should not replace PIF measurement in the DPI selection process.Trial registration:https://clinicaltrials.gov/ct2/show/NCT04532853.

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“…Prioritizing primary care respiratory research needs have been identified by the International Primary Care Respiratory Group for primary care health professionals worldwide. [ 21 ] However, a prioritized research agenda should encapsulate all relevant themes related to respiratory diseases in the context of the global fight against NCDs, infectious respiratory diseases, and the pandemic of COVID-19. This requires both respiratory-disease-targeted interventions and comprehensive NCD programs with an emphasis on health promotion, prevention, and treatment.…”

mentioning

confidence: 99%

“…Shaping Global Respiratory Disease Research Agenda. Prioritizing primary care respiratory research needs have been identified by the International Primary Care Respiratory Group for primary care health professionals worldwide [21] . However, a prioritized research agenda should encapsulate all relevant themes related to respiratory diseases in the context of the global fight against NCDs, infectious respiratory diseases, and the pandemic of COVID-19.…”

mentioning

confidence: 99%