Effect of tiotropium on quality of life in COPD: a systematic review

Kaplan, Alan

doi:10.4104/pcrj.2010.00067

Cited by 21 publications

(14 citation statements)

References 78 publications

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“…Our study also demonstrated that even the QOL of life of patients is also severely affected and is in agreement with earlier studies which have demonstrated a significant impact as evident by SGRQ and treatment was associated with an improvement in QOL symptoms [3,[15][16][17][18].…”

Section: Discussionsupporting

confidence: 93%

To Assess the Quality of Life (QOL) of Caregivers and Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)

Kumar¹,

Matreja²,

Gupta³

2012

J Allergy Ther

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Rationale: Chronic Obstructive Pulmonary Disease (COPD) is associated with physical and psychological burdens. The impact of disease has been studied on patients but it also has a profound and pervasive effect on family and friends resulting in psychological strain, social isolation, relationship strains and financial strains from the added responsibilities of managing the patients. Few studies have found a significant burden on both caregivers and patients alike, but the data from the Indian setup in lacking. Hence, we designed this study to assess the Quality of Life (QOL) of caregivers and patients suffering from COPD. Methods: A cross-sectional study was carried out with forty-six COPD patients and their primary caregivers. Patients were assessed with St. George's Respiratory Questionnaire (SGRQ), and WHO-QOL-Bref scores. The caregivers were divided into two groups. Group 1 volunteers were caregivers of patients recently diagnosed with COPD (Last 1 year), whereas Group 2 were caregivers of patients with COPD diagnosed more than 1 year back. The caregivers in both the groups were subjected to Zarit Burden Interview (ZBI) and WHO-QOL-Bref scores. Results: 46 patients and caregivers were enrolled in the study. Majority of patients were over the age of 50 years (55.67 ± 12.45), and 67% caregivers were females. Patients had poor QOL as per SGRQ. The caregivers in Group 1 had significantly lower (p < 0.05) burden as compared to Group 2 as evident by ZBI scores. The WHO-QOL-Bref scores in all the 4 domains were significantly higher in Group 1 which predicts a better quality of life. Conclusion: COPD takes a toll not only on the patient but also the caregiver of the patients. The amount of burden increases as the disease progress with worsening quality of life.

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Section: Discussionsupporting

confidence: 93%

To Assess the Quality of Life (QOL) of Caregivers and Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)

Kumar¹,

Matreja²,

Gupta³

2012

J Allergy Ther

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“…26 Many studies have demonstrated that monotherapy with long-acting bronchodilators -both LABA and LAMA -can provide clinically relevant improvements in health status of COPD patients, at least in the shorter term. [37][38][39][40][41] The addition of ICS to a long-acting bronchodilator appears to improve health status by approximately 2 units.…”

Section: Effect Of Ics On Health Statusmentioning

confidence: 99%

Risk-to-benefit ratio of inhaled corticosteroids in patients with COPD

Price

Yawn

Brusselle

et al. 2012

Primary Care Respiratory Journal

162

139

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While the pharmacological management of chronic obstructive pulmonary disease (COPD) has evolved from the drugs used to treat asthma, the treatment models are different and the two diseases require clear differential diagnosis in order to determine the correct therapeutic strategy. In contrast to the almost universal requirement for anti-inflammatory treatment of persistent asthma, the efficacy of inhaled corticosteroids (ICS) is less well established in COPD and their role in treatment is limited. There is some evidence of a preventive effect of ICS on exacerbations in patients with COPD, but there is little evidence for an effect on mortality or lung function decline. As a result, treatment guidelines recommend the use of ICS in patients with severe or very severe disease (forced expiratory volume in 1 second <50% predicted) and repeated exacerbations. Patients with frequent exacerbations -a phenotype that is stable over time -are likely to be less common among those with moderate COPD (many of whom are managed in primary care) than in those with more severe disease. The indiscriminate use of ICS in COPD may expose patients to an unnecessary increase in the risk of side-effects such as pneumonia, osteoporosis, diabetes and cataracts, while wasting healthcare spending and potentially diverting attention from other more appropriate forms of management such as pulmonary rehabilitation and maximal bronchodilator use. Physicians should carefully weigh the likely benefits of ICS use against the potential risk of side-effects and costs in individual patients with COPD.

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“…Tiotropium consistently improves symptoms and health status compared with placebo (for a comprehensive review of studies, see Kaplan et al 50 .) Figure 3 shows the effect of tiotropium on health status as measured using the St Georges Respiratory Questionnaire (SGRQ) compared with placebo across eight studies, which again varied in the severity of airflow obstruction and GOLD group of the patients included, concomitant and prior use of maintenance therapy, age and whether the Handihaler or Respimat soft mist inhaler were used to deliver the tiotropium.…”

Section: Clinical Effects Of Tiotropium In Copdmentioning

confidence: 99%

Therapeutic Role of Tiotropium in Chronic Obstructive Airways Diseases

Halpin¹

2018

BRN

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Chronic obstructive airways disease (COPD) and asthma are major causes of morbidity around the world. This review examines the evidence on the effectiveness of tiotropium as a treatment for COPD and asthma. It discusses the role of acetylcholine in airway physiology and the effects of muscarinic antagonism on airways smooth muscle, mucous secretion and inflammation. In COPD, tiotropium increases forced expiratory volume in 1 second (FEV 1) and reduces hyperinflation; it improves breathlessness, exercise capacity and health status, and it reduces exacerbation rates. Tiotropium also reduces the rate of decline in FEV 1 over 4 years in patients with an FEV 1 over 50% predicted. In asthma, when added to inhaled steroids alone or in combination with long-acting beta agonists, tiotropium improves lung function, improves asthma control and reduces exacerbations. These effects have been seen in children, adolescents and adults with asthma. Tiotropium is well tolerated, with a low incidence of adverse events.

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Effect of tiotropium on quality of life in COPD: a systematic review

Abstract: Background: Chronic obstructive pulmonary disease (COPD) greatly affects quality of life (QoL). Although QoL is a key concern for the patient, primary endpoints in most clinical trials are objective measures of disease progression.

Cited by 21 publications

References 78 publications

To Assess the Quality of Life (QOL) of Caregivers and Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)

To Assess the Quality of Life (QOL) of Caregivers and Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)

Risk-to-benefit ratio of inhaled corticosteroids in patients with COPD

Therapeutic Role of Tiotropium in Chronic Obstructive Airways Diseases

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