10 Years After EPISCAN: A New Study on the Prevalence of COPD in Spain—A Summary of the EPISCAN II Protocol

Alfageme, Inmaculada; Lucas, Pilar de; Ancochea, Julio; Miravitlles, Marc; Soler-Cataluña, Juan José; García‐Río, Francisco; Casanova, Ciro; González-Moro, José Miguel Rodríguez; Cosío, Borja G.; Sánchez, Guadalupe; Soriano, Joan B.

doi:10.1016/j.arbr.2018.11.008

Cited by 14 publications

(20 citation statements)

References 39 publications

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“…In dieser Hinsicht haben die gegenwärtigen Ansätze, bei denen die medizinische Versorgung entsprechend dem Risikoniveau [3] oder Phänotyp [4] festgelegt wird, nicht zu allgemein akzeptierten Ansätzen und zu heftigen Auseinandersetzungen geführt. Aufgrund ihrer hohen Prävalenz in der Bevölkerung [6, 7] und der erheblichen Belastung für die Patienten und das Gesundheitssystem ist die COPD jedoch eine Erkrankung, bei der die medizinische Behandlung stärker personalisiert erfolgen sollte.…”

Section: Einführungunclassified

Einbeziehung von Komorbiditäten und phänotypbasierter Medizin beim patientenzentrierten COPD-Management

et al. 2021

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Trotz der jüngsten bedeutenden Innovationen in der Behandlung der chronisch-obstruktiven Lungenerkrankung (chronic obstructive pulmonary disease, COPD) wurden in der patientenzentrierten Medizin keine wesentlichen Fortschritte erzielt. Die Empfehlungen der aktuellen Leitlinien basieren auf den Durchschnittsergebnissen klinischer Studien, was zur Folge hat, dass die medizinische Praxis als «mittelwertbasiert» bezeichnet werden kann. Auf der Patientenebene ist das therapeutische Ansprechen jedoch variabel. Zudem führt die Variabilität des klinischen Bildes im Wechselspiel mit den Komorbiditäten dazu, dass ein komplexes klinisches Szenario entsteht, mit dem die Ärzte umgehen müssen. Aus diesem Grund gibt es bislang keinen Konsens über einen praktischen Ansatz bei der Kombination von Komorbiditäten und Markern des klinischen Bildes im Therapie-Algorithmus. Diesbezüglich steht der Arzt ab dem ersten Patientenbesuch vor vier wichtigen Dilemmata: 1. Stellung der korrekten Diagnose «COPD» in Abgrenzung zu anderen Atemwegserkrankungen wie etwa Bronchialasthma; 2. Festlegung des initialen Therapieansatzes auf Grundlage der klinischen Merkmale des jeweiligen Falles; 3. Festlegung der diagnostischen Strategie für Patienten, die nicht auf die Therapie ansprechen; 4. Festlegung einer Strategie für die Verlaufskontrolle mit zwei genau definierten Zeiträumen, je nachdem, ob eine engmaschige oder eine langfristige Verlaufskontrolle erforderlich ist. Die vorliegende Arbeit geht auf die Hauptdilemmata bei der Suche nach einem patientenzentrierten Ansatz für das COPD-Management ein und liefert Vorschläge, wie diese alle in einer einzigen, einfach anwendbaren Strategie kombiniert werden können.

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Section: Einführungunclassified

Einbeziehung von Komorbiditäten und phänotypbasierter Medizin beim patientenzentrierten COPD-Management

et al. 2021

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“…IBERPOC (prevalence of chronic obstructive pulmonary disease in Spain) and EPISCAN (The Epidemiologic Study of COPD in Spain) studies reported the prevalence of ACOPD among the Spanish population between the ages of 40 and 69 y to be 9.1% 4 and 10.2% for individuals between 40 and 80 years of age. 5 Despite these figures, ACOPD remains significantly underdiagnosed in Spain, where there is a greater risk for acute episodes and mortality (29,000 people/y) than in neighbouring countries. 5 APE prevalence is also substantial (6.8%) due to the high prevalence of cardiovascular risk factors contributing to cardiac failure.…”

Section: Introductionmentioning

confidence: 99%

“…5 Despite these figures, ACOPD remains significantly underdiagnosed in Spain, where there is a greater risk for acute episodes and mortality (29,000 people/y) than in neighbouring countries. 5 APE prevalence is also substantial (6.8%) due to the high prevalence of cardiovascular risk factors contributing to cardiac failure. 6 In fact, APE is responsible for 13.1% of all in-hospital deaths in Spain.…”

Section: Introductionmentioning

confidence: 99%

Protocol for assessing mortality reduction with the early use of noninvasive ventilation in prehospital emergency services: A multicentre, observational cohort study in Madrid, Spain

Garcia

Sanz

Gutiérrez-Misis

et al. 2021

Australian Critical Care

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Background: Acute respiratory failure (ARF) has become one of the most prevalent serious pathologies encountered in the emergency medical service (EMS). In hospital settings, noninvasive ventilation (NIV) therapy prevents complications from more aggressive treatments for that condition. However, the scarce evidence on the benefits of NIV in prehospital EMS (i.e., during transport to the hospital) is inconclusive. Objectives: To determine whether the administration of NIV during prehospital EMS in cases of ARF reduces in-hospital mortality compared with starting NIV on arrival to in-patient EMS. Methods: This is a multicentre, observational, prospective cohort study. We recruited a total of 317 patients from the Madrid region (Spain) who were prescribed NIV for their ARF using a nonprobabilistic consecutive sampling method. Analyses of the main outcome (in-hospital mortality) and secondary outcomes (length of hospital stay, readmissions, percentage of intensive care unit admissions, and costeffectiveness) will include descriptive analyses of patients' characteristics, as well as bivariate and multivariate analyses and cost-effectiveness analysis. Discussion: This study will provide data on NIV management in prehospital and in-patient EMS in patients with ARF. Results will contribute to the existing evidence on the benefits of NIV in the context of prehospital EMS while underlining the importance of a standardized formal training for physicians and nurses working in prehospital and in-patient EMSs. Conclusion:The VentilaMadrid study will provide valuable data on the clinical factors of patients receiving NIV in prehospital EMS. Further, were our hypothesis to be confirmed, our results would strongly suggest that the administration of NIV in prehospital EMS by medical and nursing profesionals formally trained in the technique reduces mortality and improves prognoses.

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“…In this regard, current approaches establishing medical care according to risk level [ 3 ] or phenotype [ 4 ] have not yielded universally adopted approaches, and have given rise to major controversy [ 5 ]. However, with a high prevalence in the population [ 6 , 7 ] and a considerable burden on patients and the health system, COPD is a condition in which more personalized medical treatment should be given.…”

Section: Introductionmentioning

confidence: 99%

Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD

Lόpez-Campos

Ruiz-Duque

Carrasco‐Hernández

et al. 2020

JCM

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Despite recent notable innovations in the management of chronic obstructive pulmonary disease (COPD), no major advances in patient-centered medicine have been achieved. Current guidelines base their proposals on the average results from clinical trials, leading to what could be termed ‘means-based’ medical practice. However, the therapeutic response is variable at the patient level. Additionally, the variability of the clinical presentation interacts with comorbidities to form a complex clinical scenario for clinicians to deal with. Consequently, no consensus has been reached over a practical approach for combining comorbidities and disease presentation markers in the therapeutic algorithm. In this context, from the patients’ first visit, the clinician faces four major dilemmas: (1) establishing the correct diagnosis of COPD as opposed to other airway diseases, such as bronchial asthma; (2) deciding on the initial therapeutic approach based on the clinical characteristics of each case; (3) setting up a study strategy for non-responding patients; (4) pursuing a follow-up strategy with two well-defined periods according to whether close or long-term follow-up is required. Here, we will address these major dilemmas in the search for a patient-centered approach to COPD management and suggest how to combine them all in a single easy-to-use strategy.

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10 Years After EPISCAN: A New Study on the Prevalence of COPD in Spain—A Summary of the EPISCAN II Protocol

Cited by 14 publications

References 39 publications

Einbeziehung von Komorbiditäten und phänotypbasierter Medizin beim patientenzentrierten COPD-Management

Einbeziehung von Komorbiditäten und phänotypbasierter Medizin beim patientenzentrierten COPD-Management

Protocol for assessing mortality reduction with the early use of noninvasive ventilation in prehospital emergency services: A multicentre, observational cohort study in Madrid, Spain

Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD

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