Predictors of inhaled corticosteroid therapy in COPD alone compared to COPD with concomitant asthma managed in primary care

Background and Objective: Inhaled corticosteroids (ICS) might be overprescribed for COPD in general practice. Our aim was to identify predictors for prescribing ICS for COPD patients with or without asthma in general practice.Methods: Participating general practitioners (GPs) (n=144) recruited patients with COPD (ICPC 2nd ed. code R95) and currently prescribed ICS (ACT code R03AK and R03BA). Data on demographics, smoking habits, spirometry, dyspnea score, and exacerbation history were retrieved from medical records. Pearson Chi-Square test was used for comparison of categorical variables and logistic regression analysis was used to identify predictors of a diagnosis of asthma.Results: A total of 2.289 patients were recruited. Compared to patients with COPD alone (n=1.749), those with COPD and asthma (n=540) were younger, had higher BMI, higher FEV1/FVC ratio (0.56 and 0.62, respectively), higher blood eosinophil count and less life-time tobacco exposure (36 and 26 pack-years, respectively). Based on the GOLD spirometry classification, patients with COPD and asthma had less severe disease compared to COPD alone (p
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research

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This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic...
Source: International Journal of Qualitative Studies on Health and Well-being - Category: International Medicine & Public Health Tags: Int J Qual Stud Health Well-being Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study analyzed cross-sectional datasets of adults (aged ≥ 40 years) in the Korean National Health and Nutrition Examination Survey 2010-2016. Health-related QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L) index score. The presence of chronic cough and other conditions were defined using structured questionnaires. RESULTS: The prevalence of chronic cough was 3.48% ± 0.17% among adults aged ≥ 40 years. The overall EQ-5D-3L index score was significantly lower in subjects with than without chronic cough (0.79 ± 0.01 vs. 0.86 ± 0.00, P
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
In this study, except for troponin elevation,Gestalt was the best predictor.The article does not specify the QT correction methodWhy is right ventricular hypertrophy (RVH) not found in this large study of syncope?  Probably because it is not common enough to be identified in a general syncope study.  Not every high risk factor will be identified in such studies, but it is obvious that RVH is a dangerous condition and that, if identified on ECG, needs further workup.  Why were so few ECG findings predictive?Because most abnormal ECG findings were considered adverse outcomes in their own right and not eva...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
CONCLUSION: Measurement of ambulatory medical care of an elderly population based on health claims data is feasible and shows differences in care processes of older and care-dependent individuals if place of residency and level of care-dependency are considered. Further development of the QIs explored should incorporate a thorough methodical foundation, particularly with regard to risk adjustment. In addition, the contribution of individual and contextual factors on QIs remains to be examined with a view to the community-dwelling care-dependent elderly and their ongoing residency in this setting. PMID: 32811774 [PubMed...
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research
According to a recentIQVIA analysis, commercial health plans have increased patients ’ average out-of-pocket costs for brand medicines by over 50% in some therapeutic areas since 2015. Notably, of the seven therapeutic areas that IQVIA analyzed, including anticoagulants, asthma/COPD, depression, diabetes, HIV, multiple sclerosis and oncology treatments, average patient cost exposu re between 2015 and 2019 saw a 32% increase for depression, a 50% increase for HIV and a 56% increase for anticoagulants. Cost exposure represents the level of cost sharing patients would have paid out of pocket if financial assistance, lik...
Source: The Catalyst - Category: Pharmaceuticals Authors: Tags: Adherence Drug Cost HIV/AIDS Out-of-Pocket Costs Let's Talk About Cost Source Type: news
CONCLUSION: Eight biased TCM constitutions were closely related to specific diseases, and could be used to guide individualized prevention and treatment. More rigorously designed studies are recommended to further verify the constitution-disease relationship. PMID: 32744037 [PubMed - in process]
Source: Journal of Traditional Chinese Medicine - Category: Complementary Medicine Authors: Tags: J Tradit Chin Med Source Type: research
Whether periodontitis is a risk factor for developing bipolar disorders (BD) has not been investigated. We aimed to determine whether periodontitis is associated with the subsequent development of BD and examine the risk factors for BD among patients with periodontitis. Using ambulatory and inpatient claims data from the National Health Insurance Research Database (NHIRD), we identified 12,337 patients who were aged at least 20 years and newly diagnosed with periodontitis between 2000 and 2004. The date of the first claim with a periodontitis diagnosis was set as the index date. For each patient with periodontitis, 4 subj...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
AbstractIntroductionPoor sleep quality in patients with chronic obstructive pulmonary disease (COPD) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD.ObjectivesWe investigated patterns of sleep disturbance and factors associated with sleep impairment in patients with COPD.MethodsThis was a prospective, multicenter cross ‐sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient‐reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. The St. George&r...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsIndividual risk assessment in older individuals should focus on inhaler technique performance (mainly on dose activation and end pause) and adherence, smoking, respiratory comorbidities and cognitive impairment. Placebo device training provided by doctors seems to best suit these patients.
Source: Drugs and Aging - Category: Geriatrics Source Type: research
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