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CME/MOC

Literature Reviews

September 2011

Tele-health

Title: Interaction Between COPD Patients and Healthcare Professionals in a Cross-Sector Tele-Rehabilitation Programme.
Authors:
Dinesen B, Andersen SK, Hejlesen O, Toft E.
Source: Stud Health Technol Inform. 2011;169:28-32.

Summary:
This paper explores how technology affects the interaction between COPD patients and healthcare professionals in a cross-sector tele-rehabilitation programme.

Nutrition

Title: Association between Ω3 and Ω6 fatty acid intakes and serum inflammatory markers in COPD.
Authors:
de Batlle J, Sauleda J, Balcells E, Gómez FP, Méndez M, Rodriguez E, Barreiro E, Ferrer JJ, Romieu I, Gea J, Antó JM, Garcia-Aymerich J; PAC-COPD Study Group.
Source: J Nutr Biochem. 2011 Sep 1. [Epub ahead of print].

Summary:
De Batlle et al. aimed to assess the relationship between dietary intake of omega-3 and omega-6 fatty acids and serum inflammatory markers in COPD. This study provides the first evidence of an association between dietary intake of omega-3 and omega-6 fatty acids and serum inflammatory markers in COPD patients.

Pulmonary rehabilitation

Title: Pulmonary rehabilitation: overwhelming evidence but lost in translation?
Authors: Johnston K, Grimmer-Somers K..
Source:
Physiother Can. 2010 Fall;62(4):368-73. Epub 2010 Oct 18.

Summary:
This report highlights the current international gap between the availability of high-quality evidence for pulmonary rehabilitation and its low level of implementation.

Title: Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients: a randomized controlled trial.
Authors: Duiverman ML, Wempe JB, Bladder G, Vonk JM, Zijlstra JG, Kerstjens HA, Wijkstra PJ.
Source: Respir Res. 2011 Aug 23;12(1):112. [Epub ahead of print].

Summary:
The aim was to compare the outcome of 2-year home-based nocturnal NIPPV in addition to rehabilitation (NIPPV + PR) with rehabilitation alone (PR) in COPD patients with chronic hypercapnic respiratory failure. The addition of NIPPV to pulmonary rehabilitation for 2 years in severe COPD patients with chronic hypercapnic respiratory failure improves HRQoL, mood, dyspnea, gas exchange, exercise tolerance and lung function decline.

Title: Exercise maintenance: COPD patients' perception and perspectives on elements of success in sustaining long-term exercise.
Authors:
Hellem E, Bruusgaard KA, Bergland A.
Source:
Physiother Theory Pract. 2011 Aug 8. [Epub ahead of print].

Summary: Hellem et al. aimed to elucidate how patients with COPD who successfully maintain a long-term exercise programme understand concordance with maintenance exercise and see potential solutions.

Title: New tools in pulmonary rehabilitation.
Authors:
Wijkstra PJ, Wempe JB.
Source:
Eur Respir J. 2011 Aug 4. [Epub ahead of print].

Summary: This paper provides an overview of new approaches being developed as an adjunct to exercise training.

Complexity of COPD

Title: Myocardial infarction and other co-morbidities in patients with chronic obstructive pulmonary disease: a Danish Nationwide Study of 7.4 million individuals.
Authors:
Sode BF, Dahl M, Nordestgaard BG.
Source:
Eur Heart J. 2011 Aug 29. [Epub ahead of print].

Summary: Sode et al. assessed the extent of myocardial infarction and other co-morbidities in individuals with chronic obstructive pulmonary disease in the general population. COPD was associated with higher rates of myocardial infarction, lung cancer, diabetes, hip fracture, and depression, but the strength of these associations was modified after a first admission for COPD.

Title: Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations.
Authors:
Roberts CM, Stone RA, Lowe D, Pursey NA, Buckingham RJ.
Source:
COPD. 2011 Aug 24. [Epub ahead of print].

Summary: This study demonstrates that co-morbidities adversely affect a range of short-term patient outcomes related to acute admission to hospital with exacerbations of COPD. Recognition of relevant accompanying diseases at admission provides an opportunity for specific interventions that may improve short-term prognosis.

Title: The Progression of Chronic Obstructive Pulmonary Disease is Heterogeneous: The Experience of the BODE Cohort.
Authors:
Casanova C, de Torres JP, Aguirre-Jaíme A, Pinto-Plata V, Marin JM, Cordoba E, Baz R, Cote C, Celli BR.
Source:
Am J Respir Crit Care Med. 2011 Aug 11. [Epub ahead of print].

Summary: Longitudinal studies evaluating individual lung function loss and other domains of COPD progression are needed. Casanova et al. concluded that the progression of COPD is very heterogeneous. A majority of patients show no statistical significant decline of FEV1 or increase in BODE. The multidimensional evaluation of COPD should offer insight into response to COPD management.

Physical inactivity and daily energy expenditure

Title: Evidence of an Early Physical Activity Reduction in Chronic Obstructive Pulmonary Disease Patients.
Authors:
Gouzi F, Préfaut C, Abdellaoui A, Vuillemin A, Molinari N, Ninot G, Caris G, Hayot M.
Source:
Arch Phys Med Rehabil. 2011 Aug 19. [Epub ahead of print].

Summary: Gouzi et al. compared the lifetime pattern of physical activity in COPD patients and sedentary healthy subjects using a questionnaire with a lifetime period of recall (Quantification de l'Activité Physique [QUANTAP] system), and to compare the pattern of physical activity reduction in COPD patients with the onset of breathlessness and other relevant clinical events in this disease (diagnosis, first rehabilitation, onset of smoking). The observation of an early physical activity reduction, preceding the onset of breathlessness, suggests the implication of prior pathologic mechanisms in the physical activity reduction of COPD patients.

Title: DEFINING THE RELATIONSHIP BETWEEN AVERAGE DAILY ENERGY EXPENDITURE, FIELD-BASED WALKING TESTS AND AEROBIC RESERVE IN COPD.
Authors:
Hill K, Dolmage TE, Woon L, Coutts D, Goldstein R, Brooks D.
Source:
Chest. 2011 Aug 11. [Epub ahead of print].

Summary: The aims of this study were to: (i) determine which tests of exercise capacity relate to average daily energy expenditure (DEE) and; (ii) quantify aerobic reserve during daily life in people with COPD. Both 6MWD and ISWD, but not VO2peak were related to DEE. As activities of daily living were performed at a high percentage of VO2peak it may be more realistic to optimise habitual DEE in COPD by increasing the frequency or duration, rather than the intensity of physical activity.

Symptoms of anxiety and depression

Title: Clinical and Economic Burden of Depression/Anxiety in Chronic Obstructive Pulmonary Disease Patients within a Managed Care Population.
Authors:
Dalal AA, Shah M, Lunacsek O, Hanania NA.
Source:
COPD. 2011 Aug 9. [Epub ahead of print].

Summary: The purpose of this study was to evaluate their impact on healthcare utilization and costs in a managed care COPD population. In the COPD population, patients with depression/anxiety have significantly higher risk of COPD exacerbations and annual all-cause and COPD-related costs than patients without these co-morbidities.