Tobacco Heating System 2.2 in Mild to Moderate Copd Subjects: An Exploratory Analysis

Ansari, Sam; Sergio, Francesco; Medlin, Loyse Felber; Lama, Nicola; Elamin, Ashraf; Haziza, Christelle

doi:10.1016/j.chest.2019.08.485

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Few had spirometry for clinical purposes prior to study enrollment, highlighting the lack of appropriate work-up for chronic lung disease. Our findings of high rates of both misdiagnosis and under-diagnosis in PLWH are similar to those amongst HIV-uninfected participants in this study and those reported in the general, non-Veteran population [12,13] . Findings were similar in sensitivity analyses in which we considered emphysema on chest CT to also signify COPD.…”

Section: Discussionsupporting

confidence: 84%

“…The greater COPD prevalence is explained only in part by the higher rates of smoking in PLWH, [1,2,5–7] and may be related to increased susceptibility to respiratory infections, immunocompromised state, and chronic inflammation [8–11] . Prior studies suggest high rates of both misdiagnosis and underdiagnosis of COPD in the general population, ranging from 60% to >90% [12,13] . COPD is misdiagnosed when patients carry the clinical diagnosis, but spirometry does not confirm airflow limitation (defined as a ratio of the forced expiratory volume in one second [FEV1] over the forced vital capacity [FVC] of <0.70, or alternatively below the lower limit of normal (LLN) on post-bronchodilator spirometry) [14,15] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A cross-sectional analysis of diagnosis and management of chronic obstructive pulmonary disease in people living with HIV

et al. 2021

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is common in people living with HIV (PLWH). We sought to evaluate the appropriateness of COPD diagnosis and management in PLWH, comparing results to HIV-uninfected persons. We conducted a cross-sectional analysis of Veterans enrolled in the Examinations of HIV-Associated Lung Emphysema study, in which all participants underwent spirometry at enrollment and reported respiratory symptoms on self-completed surveys. Primary outcomes were misdiagnosis and under-diagnosis of COPD, and the frequency and appropriateness of inhaler prescriptions. Misdiagnosis was defined as having an International Classification of Diseases (ICD)-9 diagnosis of COPD without spirometric airflow limitation (post-bronchodilator forced expiratory volume in 1-second [FEV1]/Forced vital capacity [FVC] < 0.7). Under-diagnosis was defined as having spirometry-defined COPD without a prior ICD-9 diagnosis. The analytic cohort included 183 PLWH and 152 HIV-uninfected participants. Of 25 PLWH with an ICD-9 diagnosis of COPD, 56% were misdiagnosed. Of 38 PLWH with spirometry-defined COPD, 71% were under-diagnosed. In PLWH under-diagnosed with COPD, 85% reported respiratory symptoms. Among PLWH with an ICD-9 COPD diagnosis as well as in those with spirometry-defined COPD, long-acting inhalers, particularly long-acting bronchodilators (both beta-agonists and muscarinic antagonists) were prescribed infrequently even in symptomatic individuals. Inhaled corticosteroids were the most frequently prescribed long-acting inhaler in PLWH (28%). Results were overall similar amongst the HIV-uninfected. COPD was frequently misdiagnosed and under-diagnosed in PLWH, similar to uninfected-veterans. Among PLWH with COPD and a likely indication for therapy, long-acting inhalers were prescribed infrequently, particularly guideline-concordant, first-line long-acting bronchodilators. Although not a first-line controller therapy for COPD, inhaled corticosteroids were prescribed more often.

show abstract

Section: Discussionsupporting

confidence: 84%