Incidence and risk factors of exacerbations among COPD patients in primary health care: APMPOC study

Borrell, Eulàlia; Rodriguez, Mar Pujades; Muñoz, Laura; Pera, Guillem; Montellà, Nuria; Monteagudo, Mónica; Urrea, Magalí; Puigfel, Yolanda; Negrete, A. Y. Lujano; Mezquiriz, Xavier; Domènech, Cristina; Lacasta, Anna; García, Ma Lluma; Maneus, Sandra; Tintoré, Glòria

doi:10.1186/1471-2458-9-8

Cited by 14 publications

(6 citation statements)

References 27 publications

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“…It also improves the exercise tolerance and general health condition of patients [13,14,18,25,[27][28][29]. Therefore, it seems obvious that failure to regularly treat COPD deteriorates the course of the disease and increases mortality rate, which has also been shown in the research [12,16,18,22,30].…”

Section: Discussionmentioning

confidence: 80%

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Factors Influencing Adherence to Treatment in COPD Patients and Its Relationship with Disease Exacerbations

Wiśniewski

Porzezińska

Gruchała‐Niedoszytko

et al. 2014

Advances in Respiratory Medicine

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Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in the world. Systematic treatment of COPD decreases symptoms and reduces the frequency of exacerbations and hospitalisations because of the disease. It is estimated that only 50% of patients use prescribed drugs systematically. The aim of this study was to identify the factors which can influence adherence to treatment of the patients who were treated due to exacerbation of COPD. Material and Methods: A questionnaire probe was conducted on 49 patients hospitalised at the Regional Lung and Tuberculosis Hospital in Olsztyn, Poland due to COPD exacerbation. The assessed variables were: quality of life and adherence to treatment 30 days after discharge from hospital in relationship with demographic factors, social status, disease and hospitalisation course, and relief after systematic treatment. Results: Most of the patients assessed their health condition as poor and the disease as limiting their everyday social and occupational activity. 30 days after discharge from hospital the adherence rate to therapy was only 67%. There was an association between systematic treatment and the rate of exacerbations (p = 0.045) and hospitalisations (p = 0.005) but also clinical benefit after long-term treatment (p = 0.023). There were no associations between adherence to treatment and sex, place of residence, education or occupation. Conclusions: Lack of systematic treatment is the main risk factor for COPD exacerbations and hospitalisation rate. A subjective sense of relief after drugs is a factor improving patients’ compliance.

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Section: Discussionmentioning

confidence: 80%

“…Chronic symptoms deteriorate the quality of life and limit the occupational and social lives of patients [2,[6][7][8][9]. In a natural course of COPD there are periods of exacerbations that, additionally, deteriorate the quality of life, precipitate decrease in ventilation parameters, and increase mortality rate [2,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Adherence to Treatment in COPD Patients and Its Relationship with Disease Exacerbations

Wiśniewski

Porzezińska

Gruchała‐Niedoszytko

et al. 2014

Advances in Respiratory Medicine

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“…15 Being its major cause, infection accounted for 50%–70% AECOPD occurrences worldwide and 80%–90% AECOPD occurrences in the People’s Republic of China alone. 16 , 17 Other predisposing factors include environmental pollution, low temperatures, and concomitant heart failure. 18 , 19 Subsequent onset of acute respiratory failure (ARF) may result if AECOPD are accompanied by bronchial infections, bronchospasm, left ventricular failure, pneumonia, pneumothorax, or thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

The optimum timing to wean invasive ventilation for patients with AECOPD or COPD with pulmonary infection

Song

Chen

Zhan

et al. 2016

COPD

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COPD is characterized by a progressive decline in lung function and mental and physical comorbidities. It is a significant burden worldwide due to its growing prevalence, comorbidities, and mortality. Complication by bronchial-pulmonary infection causes 50%–90% of acute exacerbations of COPD (AECOPD), which may lead to the aggregation of COPD symptoms and the development of acute respiratory failure. Non-invasive or invasive ventilation (IV) is usually implemented to treat acute respiratory failure. However, ventilatory support (mainly IV) should be discarded as soon as possible to prevent the onset of time-dependent complications. To withdraw IV, an optimum timing has to be selected based on weaning assessment and spontaneous breathing trial or replacement of IV by non-IV at pulmonary infection control window. The former method is more suitable for patients with AECOPD without significant bronchial-pulmonary infection while the latter method is more suitable for patients with AECOPD with acute significant bronchial-pulmonary infection.

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“…A recent study demonstrated an increased risk for AECOPD associated with HIV infection in a study of 167 patients in the AIDS Link to Intravenous Drug Use (ALIVE) cohort[24]. However, while risk factors have been characterized for AECOPD in HIV-uninfected (uninfected) individuals[25], they have not been well characterized in the HIV-infected population. Understanding AECOPD risk factors in HIV-infected persons is important to improve detection of disease, ensure appropriate care in the acute setting, develop strategies for prevention and to tailor long-term disease management, all of which may differ compared to uninfected persons.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients

Depp¹,

McGinnis²,

Kraemer

et al. 2015

AIDS

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Objective To determine the association between HIV infection and other risk factors for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Design Longitudinal, national Veterans Aging Cohort Study (VACS) including 43,618 HIV-infected and 86,492 uninfected Veterans. Methods AECOPD was defined as an inpatient or outpatient COPD ICD-9 diagnosis accompanied by steroid and/or antibiotic prescription within 5 days. We calculated incident rate ratios [IRR] and 95% confidence intervals (CI) for first AECOPD over 2 years and used Poisson regression models to adjust for risk factors. Results Over 234,099 person-years of follow-up, 1,428 HIV-infected and 2,104 uninfected patients had at least one AECOPD. HIV-infected patients had an increased rate of AECOPD compared with uninfected (18.8 vs. 13.3 per 1000 person-years, p<0.001). In adjusted models, AECOPD risk was greater in HIV-infected individuals overall (IRR 1.54; 95% CI 1.44 – 1.65), particularly in those with more severe immune suppression when stratified by CD4 cell count (cells/mm3) compared to uninfected (HIV-infected CD4<200: IRR 2.30, 95% CI 2.10-2.53, HIV-infected CD4 ≥200-349: IRR 1.32, 95% CI 1.15-1.51, HIV-infected CD4≥350: IRR 0.99, 95% CI 0.88-1.10). HIV infection also modified the association between current smoking and alcohol-related diagnoses with risk for AECOPD such that interaction terms for HIV and current smoking or HIV and alcohol-related diagnoses were each significantly associated with AECOPD. Conclusions HIV infection, especially with lower CD4 count, is an independent risk factor for AECOPD. Enhanced susceptibility to harm from current smoking or unhealthy alcohol use in HIV-infected patients may also contribute to the greater rate of AECOPD.

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Incidence and risk factors of exacerbations among COPD patients in primary health care: APMPOC study

Cited by 14 publications

References 27 publications

Factors Influencing Adherence to Treatment in COPD Patients and Its Relationship with Disease Exacerbations

Factors Influencing Adherence to Treatment in COPD Patients and Its Relationship with Disease Exacerbations

The optimum timing to wean invasive ventilation for patients with AECOPD or COPD with pulmonary infection

Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients

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