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August 2011

PR Literature Reviews

Mood status

Title: Anxiety and Depression during Hospital Treatment of Exacerbation of Chronic Obstructive Pulmonary Disease.
Authors:
Regvat J, Zmitek A, Vegnuti M, Košnik M, Suškovic S.
Source:
J Int Med Res. 2011;39(3):1028-38.

Summary: This study investigated the prevalence, risk factors and rate of recognition of anxiety and depression in 50 patients hospitalized for exacerbation of COPD. The results suggest that patients with mental disorders are referred and admitted to hospital earlier in the course of a COPD exacerbation due to earlier and more intense perception of dyspnoea.

Title: The management of depressive symptoms in patients with COPD: a postal survey of general practitioners.
Authors:
Yohannes AM, Hann M, Sibbald B.
Source:
Prim Health Care Res Dev. 2011 Jul;12(3):237-44.

Summary: Yohannes et al. examined the management of depression by general practitioners (GPs), through the use of case vignettes, in patients with chronic obstructive pulmonary disease (COPD), severe osteoarthritis and depressive symptoms alone. GPs in England were able to diagnose depression from the vignettes and plan appropriate treatment strategies in patients with chronic diseases. This should be complemented with thorough physical examination by GPs to rule out other factors such as the impact of physical illness. GPs believe depression interferes with patient self-management of COPD.

Title: Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease.
Authors:
Cheung G, Patrick C, Sullivan G, Cooray M, Chang CL.
Source:
Int Psychogeriatr. 2011 Jul 28:1-9. [Epub ahead of print].

Summary: This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD, i.e. the Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS). Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

Title: Relationship Between Depressive Symptoms and Hypogonadism in Men with COPD.
Authors: Halabi S, Collins EG, Thorevska N, Tobin MJ, Laghi F.
Source:
COPD. 2011 Jul 20. [Epub ahead of print]

Summary: Halabi et al. hypothesized that significant depressive symptoms would be associated with hypogonadism in men with COPD. After controlling for confounders, however, gonadal state was not associated with severe depressive symptoms. Similarly, gonadal state was not associated with mood and motivation subscale scores of the GDS. In conclusion, presence of significant depressive symptoms was not associated with hypogonadism in men with COPD.

Body composition

Title: Obesity and COPD: Associated Symptoms, Health-related Quality of Life, and Medication Use.
Authors:
Cecere LM, Littman AJ, Slatore CG, Udris EM, Bryson CL, Boyko EJ, Pierson DJ, Au DH.
Source:
COPD. 2011 Aug 2. [Epub ahead of print].

Summary: Cecere et al. compared dyspnea, health-related quality of life (HRQoL), exacerbations, and inhaled medication use among patients who are overweight and obese to those of normal weight with COPD. Despite having less severe lung disease, obese patients reported increased dyspnea and poorer HRQoL than normal weight patients. The greater number of inhaled medications prescribed for obese patients may represent overuse.

Title: Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease.
Authors:
Lainscak M, von Haehling S, Doehner W, Sarc I, Jeric T, Ziherl K, Kosnik M, Anker SD, Suskovic S.
Source:
J Cachex Sarcopenia Muscle. 2011 Jun;2(2):81-86. Epub 2011 Mar 1.

Summary: Lainscak et al. aimed to analyse the association between BMI and mortality in acute exacerbation of COPD. Low BMI below 21 kg/m(2) is frequent in patients hospitalized due to acute exacerbation of COPD. Higher BMI was independently predictive of better long-term survival. A better outcome in obese patients compared to normal weight is in contrast to primary prevention data but concurs with observations of an obesity paradox in other cardiovascular diseases.

Complexity of COPD

Title: Treating the systemic effects of chronic obstructive pulmonary disease.
Authors:
Vogelmeier CF, Wouters EF.
Source:
Proc Am Thorac Soc. 2011 Aug;8(4):376-9.

Summary: This is a narrative review of the systemic effects of COPD.

Title: Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.
Authors:
Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schünemann H, Wedzicha W, Macdonald R, Shekelle P; for the American College of Physicians, the American College of Chest Physicians, the American Thoracic Society, and the European Respiratory Society.
Source:
Ann Intern Med. 2011 Aug 2;155(3):179-191.

Summary: This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable chronic obstructive pulmonary disease (COPD) and is intended for clinicians who manage patients with COPD. This guideline addresses the value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies, pulmonary rehabilitation programs, and supplemental oxygen therapy.

Title: Effect of an action plan with ongoing support by a case manager on exacerbation-related outcome in patients with COPD: a multicentre randomised controlled trial.
Authors:
Trappenburg JC, Monninkhof EM, Bourbeau J, Troosters T, Schrijvers AJ, Verheij TJ, Lammers JW.
Source:
Thorax. 2011 Jul 23. [Epub ahead of print].

Summary: This multicentre randomised controlled trial evaluates the hypothesis that individualised APs reduce exacerbation recovery time. This study shows that an individualised AP, including ongoing support by a case manager, decreases the impact of exacerbations on health status and tends to accelerate recovery. APs can be considered a key component of self-management programmes in patients with COPD.

Physical function

Title: Role of clinical frailty on long-term mortality of elderly subjects with and without chronic obstructive pulmonary disease.
Authors:
Galizia G, Cacciatore F, Testa G, Della-Morte D, Mazzella F, Langellotto A, Raucci C, Gargiulo G, Ferrara N, Rengo F, Abete P.
Source:
Aging Clin Exp Res. 2011 Apr;23(2):118-25.

Summary: This study examined the predictive role of frailty on long-term mortality in elderly subjects with and without COPD. Long-term mortality was higher in elderly subjects with than in those without COPD. The clinical frailty score also significantly predicted mortality in subjects without and, even more, in those with COPD. Thus, clinical frailty may be considered a new prognostic factor to identify COPD subjects at high risk of mortality.

Title: Is age-related decline in lean mass and physical function accelerated by obstructive lung disease or smoking?
Authors:
van den Borst B, Koster A, Yu B, Gosker HR, Meibohm B, Bauer DC, Kritchevsky SB, Liu Y, Newman AB, Harris TB, Schols AM; For the Health ABC Study.
Source:
Thorax. 2011 Jul 1. [Epub ahead of print].

Summary: A study was undertaken to investigate whether OLD and smoking accelerate the ageing-related decline in lean mass and physical functioning. Initially well-functioning older adults with mild-to-moderate OLD and smokers without OLD have a comparable compromised baseline profile of body composition and physical functioning, while 7-year longitudinal trajectories are to a large extent comparable to those observed in never-smokers without OLD. This suggests a common insult earlier in life related to smoking.

Physical activity

Title: Activity promotion: a paradigm shift for chronic obstructive pulmonary disease therapeutics.
Author: Casaburi R.
Source:
Proc Am Thorac Soc. 2011 Aug;8(4):334-7.

Summary: This narrative review focuses on coupling interventions permissive of improved exercise tolerance with behaviour modification approaches that empower lifestyle modification. In particular, pulmonary rehabilitation seems ripe for augmentation with scientifically based strategies for activity promotion.

Title: Association of daily physical activity volume and intensity with COPD severity.
Authors:
Jehn M, Schmidt-Trucksäss A, Meyer A, Schindler C, Tamm M, Stolz D.
Source:
Respir Med. 2011 Jul 29. [Epub ahead of print].

Summary: The purpose of this study was to assess whether daily walking activity is indicative of disease severity in patients with COPD. Daily walking activity, in particular walking intensity, is significant predictor of disease severity in patients with COPD. Objective measures of habitual activity might provide additive value in assessing the likelihood of poor prognosis in this patient cohort.

Title: Does the BODE index reflect the level of physical activity in daily life in patients with COPD?
Authors:
Mantoani LC, Hernandes NA, Guimarães MM, Vitorasso RL, Probst VS, Pitta F.
Source:
Rev Bras Fisioter. 2011 Apr;15(2):131-7.

Summary:Mantoani et al. studied the relationship between the level of physical activity in daily life and disease severity assessed by the BODE index in patients with chronic obstructive pulmonary disease (COPD). The level of physical activity in daily life has a modest correlation with the classification of COPD severity assessed by the BODE index, reflecting only differences between patients with classified as mild-moderate and severe-very severe COPD.

Title: Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review.
Authors:
Bossenbroek L, de Greef MH, Wempe JB, Krijnen WP, Ten Hacken NH.
Source:
COPD. 2011 Jul 5. [Epub ahead of print].

Summary: The aim of this review is to describe daily physical activity of COPD patients, and to examine its relationship with demographic factors, pulmonary function, physical fitness, systemic inflammation and quality of life.

Exercise testing

Title: Six-minute walk distance as a marker for disability and complaints in patients with systemic sclerosis. Auhtors: Deuschle K, Weinert K, Becker MO, Backhaus M, Huscher D, Riemekasten G.
Source:
Clin Exp Rheumatol. 2011 Mar-Apr;29(2 Suppl 65):S53-9. Epub 2011 May 13.

Summary: Deuschle et al. have analysed whether 6MWD is associated with clinical parameters obtained by an extended standardised assessment of SSc patients. 6MWD is a surrogate marker for disability and complaints in SSc patients. Therefore, 6MWT could provide a valuable outcome parameter although it lacks organ specificity.

Title: Should oxyhaemoglobin saturation be monitored continuously during the 6-minute walk test?
Authors:
Fiore C, Lee A, McDonald C, Hill C, Holland A.
Source:
Chron Respir Dis. 2011;8(3):181-4.

Summary: The aim of this study was to determine whether the nadir SpO(2) differs from the end-6MWT SpO(2) in patients with chronic respiratory disease. For most patients with chronic respiratory disease, the end SpO(2) and the nadir SpO(2) are similar during the 6MWT. However, the end SpO(2) does not give an accurate estimate of nadir SpO(2) in patients who rest. Consideration should be given to the constant monitoring of SpO(2) during the 6MWT.

Title: Predicting Outcomes from 6-Minute Walk Distance in Chronic Obstructive Pulmonary Disease.
Authors: Spruit MA, Polkey MI, Celli B, Edwards LD, Watkins ML, Pinto-Plata V, Vestbo J, Calverley PM, Tal-Singer R, Agusti A, Coxson HO, Lomas DA, Macnee W, Rennard S, Silverman EK, Crim CC, Yates J, Wouters EF; on behalf of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study investigators.
Source:
J Am Med Dir Assoc. 2011 Jul 19. [Epub ahead of print].

Summary: The purpose of this study was to improve the utility of the 6MWT for patient and health care system management, the interpretation of the functional status measure in relation to death and hospitalization should be elucidated, using the 3-year ECLIPSE data. The 6MWD provides prognostic information that may be useful for identifying high-risk patients with COPD.

Title: Six-Minute Walking Distance in Women with COPD.
Authors:
Torres JP, Casanova C, Cote CG, López MV, Díaz O, María Marin J, Pinto-Plata V, Montes de Oca M, Aguirre-Jaime A, Celli BR.
Source:
COPD. 2011 Jul 18. [Epub ahead of print].

Summary: Purpose of this study was to explore if the 350 meters threshold differentiates survival in women as it does in men. In women with COPD, the 6MWD decreases with age and GOLD stages. A 350 m distance is a valid threshold to differentiate survival. Further studies in different settings should confirm our findings.

Title: Gait speed as a functional capacity indicator in patients with chronic obstructive pulmonary disease.
Authors:
Ilgin D, Ozalevli S, Kilinc O, Sevinc C, Cimrin AH, Ucan ES.
Source:
Ann Thorac Med. 2011 Jul;6(3):141-6.

Summary: The aim of this study was to assess the use of gait speed as a functional capacity indicator in COPD patients. Gait speed slows down with increasing COPD severity. Also, gait speed has correlations with age, clinical symptoms, pulmonary functions, and quality of life scores in COPD patients. Thus, we consider that gait speed might be used as a functional capacity indicator, especially for patients with severe and very severe COPD.

Title: Chester Step Test in Patients With COPD: Reliability and Correlation With Pulmonary Function Test Results.
Authors: de Camargo AA, Justino T, de Andrade CH, Malaguti C, Dal Corso S.
Source:
Respir Care. 2011 Jul;56(7):995-1001.

Summary: This study aimed to determine the reliability of the Chester step test in patients with COPD and correlation with pulmonary function test and exercise test results. Despite being highly reproducible, the Chester step test had a very short duration in patients with COPD. The number of steps incremented in each stage seems to be too large for these patients. An adaptation of the Chester step test should be considered for patients with COPD.

Palliative care

Title: Palliative care or end-of-life care in advanced chronic obstructive pulmonary disease A prospective community survey.
Authors:
White P, White S, Edmonds P, Gysels M, Moxham J, Seed P, Shipman C.
Source:
Br J Gen Pract. 2011 Jun;61(587):362-70.

Summary: White et al. aimed to determine palliative care needs in advanced COPD. Needs in advanced COPD were considerable, with many reporting severe intractable breathlessness. Palliation of breathlessness was a priority, but discussion of need was seldom in terms of 'end-of-life care'.

Exercise training and pulmonary rehabilitation

Title: The Effect of Pulmonary Rehabilitation on Critical Walk Speed in Chronic Obstructive Pulmonary Disease: A Comparison with Self-Paced Walks.
Authors:
Dolmage TE, Evans RA, Hill K, Blouin M, Brooks D, Goldstein RS.
Source:
Chest. 2011 Jul 21. [Epub ahead of print].

Summary: The purpose was to: 1) determine the effect of pulmonary rehabilitation on the critical speed; 2) compare the critical speed with the speed chosen during self-paced walking. Patients with COPD increase their critical walk speed after pulmonary rehabilitation. The pace chosen during common walk tasks is closely related to critical speed; this relationship is altered after rehabilitation.

Title: Trajectories of Endurance Activity following Pulmonary Rehabilitation in COPD Patients.
Authors:
Soicher JE, Mayo NE, Gauvin L, Hanley JA, Bourbeau J.
Source:
Eur Respir J. 2011 Jul 7. [Epub ahead of print].

Summary: The objectives of this study were to identify patterns of endurance activity after completion of pulmonary rehabilitation and to characterize people who succeed and those who have difficulty maintaining endurance activity. Soicher et al. concluded that pulmonary rehabilitation may need to include behavioural interventions aimed at minimizing barriers.

Title: Strategies of muscle training in very severe COPD patients.
Author: Vogiatzis I.
Source:
Eur Respir J. 2011 Jul 7. [Epub ahead of print].

Summary: The present review article explores the application of strategies that optimize exercise tolerance by reducing dyspnoea sensations, namely non-invasive mechanical ventilation, oxygen and/or heliox supplementation.

Title: Eccentric Cycle Exercise in Severe COPD: Feasibility of Application.
Authors:
Rocha Vieira DS, Baril J, Richard R, Perrault H, Bourbeau J, Taivassalo T.
Source:
COPD. 2011 Jul 5. [Epub ahead of print].

Summary: This study assessed the feasibility of applying an eccentric cycling protocol, based on progressive muscle overload, in six severe COPD patients with the aim of minimizing side effects and maximizing compliance. This study showed that an eccentric cycling protocol based on progressive increases in workload is feasible in severe COPD, with no side effects and high compliance, thus warranting further study into its efficacy as a training intervention.

Title: Pulmonary rehabilitation in the United Kingdom.
Authors:
Yohannes A, Stone R, Lowe D, Pursey N, Buckingham R, Roberts C.
Source:
Chron Respir Dis. 2011 Jul 1. [Epub ahead of print].

Summary: Yohannes et al. audited the UK provision of pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) and the quality of the programmes provided against national standards. Despite widespread provision of PR in the UK, the quality of programmes is variable and often less than satisfactory. Lack of funding is cited as a primary barrier to all eligible COPD patients not receiving PR. Those responsible for PR must act to improve the quality of services and audit their effectiveness before service expansion to meet future demand that can be justified.

Title: The effectiveness of nurse-led, home-based pulmonary rehabilitation in patients with COPD in Turkey.
Authors:
Akinci AC, Olgun N.
Source:
Rehabil Nurs. 2011 Jul-Aug;36(4):159-65.

Summary: The goal of this study was to determine the effectiveness of nurse-led, home-based pulmonary rehabilitation in patients with stage 3 or 4 chronic obstructive pulmonary disease (COPD), according to the Global Initiative for COPD (GOLD) staging system. The study showed that the nurse-led, home-based pulmonary rehabilitation program had positive effects on the patients with COPD.

Health education

Title: What we can say: disease illiteracy.
Authors:
Beniwal S, Sharma BB, Singh V.
Source:
J Assoc Physicians India. 2011 Jun;59:360-4.

Summary: Beniwal et al. aimed to study the awareness, attitude and behaviour of patients with chronic disease in those who come for follow-up, about nature of their disease, compliance to drugs and precautions. A majority of patients were ignorant about their disease, importance of compliance to medicines and about precautions of the disease. Coronary artery disease patients were most ignorant people among chronic patients. It emphasizes the need of proper patient education

Title: Disparities by Education Level in Outcomes of a Self-Management Intervention: The DELTA Trial in the Netherlands.
Authors:
Bosma H, Lamers F, Jonkers CC, van Eijk JT.
Source:
Psychiatr Serv. 2011 Jul;62(7):793-5.

Summary: This study examined whether education level was associated with benefits derived from a self-management intervention. Only more highly educated patients profited from a cognitive-behavioural approach to self-management. Patients with chronic conditions who have less education may derive greater benefits if environmental adversities or lower cognitive abilities are taken into account.

Self-efficacy

Title: Measuring a change in self-efficacy following Pulmonary Rehabilitation: An evaluation of the PRAISE tool.
Authors:
Vincent E, Sewell L, Wagg K, Deacon S, Williams J, Singh S.
Source:
Chest. 2011 Jul 7. [Epub ahead of print].

Summary: Vincent et al. investigated the reproducibility and sensitivity of PRAISE (Pulmonary Rehabilitation Adapted Index of Self-efficacy); a tool adapted from the General Self-efficacy Scale (GSE) to measure the dimension of self-efficacy at the time of a course of PR. The PRAISE tool is a reliable and sensitive measure of self-efficacy for patients with COPD attending PR.

Tele-monitoring

Title: Telehealthcare for chronic obstructive pulmonary disease.
Authors:
McLean S, Nurmatov U, Liu JL, Pagliari C, Car J, Sheikh A.
Source:
Cochrane Database Syst Rev. 2011 Jul 6;7:CD007718.

Summary: McLean et al. aimed to review the effectiveness of telehealthcare for COPD compared with usual face-to-face care. Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages.