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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By ALYA AHMAD, MD Call it what you want, white privilege and health disparity appear to be two sides of the same coin. We used to consider ethnic or genetic variants as risk factors, prognostic to health conditions. However, the social determinants of health (SDOH) have increasingly become more relevant as causes of disease prevalence and complexity in health care. As a pediatric hospitalist in the San Joaquin Valley region, I encounter these social determinants daily. They were particularly evident as I treated a 12-year old Hispanic boy who was admitted with a ruptured appendix and developed a complicated abscess,...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health disparities Medical Practice Patients Alya Ahmad California health disparity health equity San Joaquin Valley SDoH Social Determinants of Health Source Type: blogs
In conclusion, this study suggests that epigenetic age acceleration is significantly associated with lung function in women older than 50 years. We hypothesised that this could be due to menopause. However, we have observed that menopause has minimal effect and therefore there is possibility of other unknown physiological factors at older age in females mediating the epigenetic age acceleration effect on lung function. While, it is still unknown what exactly epigenetic aging from DNA methylation measures, this study suggests it can be utilised as one of the important factors to assess women's lung health in old age. DNA me...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
OBJECTIVES: To estimate the adult health burden and costs in California during 2013 associated with adults' prior Adverse Childhood Experiences (ACEs). METHODS: We analyzed five ACEs-linked conditions (asthma, arthritis, COPD, depression, and cardi...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
Undergoing earlier menopause is a sign of a greater burden of age-related damage and dysfunction, so it should not be surprising to see that this correlates with a greater incidence of chronic disease in the years thereafter. People with a greater burden of cell and tissue damage tend to exhibit all of the manifestations of aging earlier than their less damaged peers. These variations in damage burden and consequences from individual to individual are near all the results of lifestyle choices, particularly smoking, weight, and exercise, and environmental factors such as exposure to chronic viral infection. Genetics plays o...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
Medicated obstructive pulmonary disease (asthma or COPD) has been associated with depression. Yet, there is little knowledge of the interplay of contributing social, biological, behavioral and psychological factors in the community. The study was conducted...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Risk Factor Prevalence, Injury Occurrence Source Type: news
ConclusionHigh-intensity exercise training generates similar benefits in patients with COPD regardless of whether presenting asthma overlap or not.
Source: Lung - Category: Respiratory Medicine Source Type: research
Purpose of review Severe asthma is often associated with numerous comorbidities that complicate disease management and affect patient's outcomes. They contribute to poor disease control and mimic asthma symptoms. Although some comorbidities such as obstructive sleep apnea, bronchiectasis, and chronic obstructive pulmonary disease are generally well recognized, many other may remain undiagnosed but may be detected in an expert specialist setting. The management of comorbidities seems to improve asthma outcomes, and optimizes therapy by avoiding overtreatment. The present review provides recent knowledge regarding the most...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: ASTHMA: Edited by Nicola A. Hanania, Zuzana Diamant, and Maarten van den Berge Source Type: research
Conclusion: The vast majority of patients gained a clinically important improvement. Symptom burden may be more important for selecting patients for PR than diagnosis.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and chronic care Source Type: research
Current available data regarding the efficacy of german Disease Management Programs (DMP) are only related to data which are entered into official documentation sheets of health care insurance / health care providers. However, no data evaluate the DMP or the incorporated educational programs from patients perspective.Therefore a cross-sectional trial in patients with Asthma (AB) and COPD, respectively, in 13 primary care practices and 26 specialist practices in Germany was performed. This subgroup analysis evaluates the effects of the DMP COPD in respect to the different disease severity in COPD.Patients took part in the D...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and chronic care Source Type: research
This study aimed to compare the COPD severity (GOLD III-IV vs I-II) in both women and men in PALOMB cohort.Diagnosed COPD patients were included by their pulmonologists. The following variables were collected: age, sex, BMI, FEV1, dyspnea (mMRC), the frequency of exacerbations, static hyperinflation (RV/TLC ≥130%) and comorbidities.35.64% of 2,259 COPD patients followed were women (64 average age). Statistically significant (P≤0.001) findings in female COPD patients were as follows: younger, underweight, more likely to be current cigarette smokers, more frequent static hyperinflation (76.1% vs 70.6%) and higher dyspn...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
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