Research priorities for exacerbations of COPD

Alqahtani, Jaber S; Aquilina, Julian; Bafadhel, Mona; Bolton, Charlotte E.; Burgoyne, Teresa; Holmes, Steve; King, Joanne; Loots, John; McCarthy, Joan; Quint, Jennifer; Ridsdale, Heidi A; Sapey, Elizabeth; Upadhyaya, Sheela; Wilkinson, Tom; Hurst, John R.

doi:10.1016/s2213-2600(21)00227-7

Cited by 35 publications

(30 citation statements)

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“…Data for community-treated exacerbations were inconclusive and need further investigation. This data is the first to provide pooled evidence supporting the potential effectiveness of COVID-19 preventative interventions in reducing the transmission of respiratory viruses, ultimately reducing admissions for COPD exacerbations–a major area of unmet clinical need and research priority [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Including such measures could potentially also reduce the high burden of hospital re-admissions for COPD exacerbations [ 37 , 38 ]. Novel strategies to prevent COPD exacerbations have been identified as a top priority by patients and clinicians in a recent research prioritisation exercise [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…This is an important area to explore because exacerbations have been identified as the most disruptive aspect of COPD by patients [ 12 ], current exacerbation reduction interventions are only partially effective even when deployed optimally [ 3 ], and COPD guidelines such as the GOLD document [ 3 ] and that from the European Respiratory Society/American Thoracic Society [ 13 ] make no mention of opportunities to reduce exacerbations through physical interventions to reduce the risk of acquiring respiratory viruses. A recent patient-clinician research prioritisation has identified better prevention of exacerbations as the top priority for COPD exacerbation research [ 14 ]. Therefore, this systematic review and meta-analysis aims to assess the relationship between COVID-19 -related restrictions and changes in hospital admission for COPD exacerbation.…”

Section: Introductionmentioning

confidence: 99%

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Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Oyelade²,

et al. 2021

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Background Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44–0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Oyelade²,

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Including such measures could potentially also reduce the high burden of hospital re-admissions for COPD exacerbations [38,39]. Novel strategies to prevent COPD exacerbations have been identified as a top priority by patients and clinicians in a recent research prioritisation exercise [14].…”

Section: Discussionmentioning

confidence: 99%

“…This is important because exacerbations have been identified as the most disruptive aspect of COPD by patients [12], current exacerbation reduction interventions are only partially effective even when deployed optimally [3], and COPD guidelines such as the GOLD document [3] and that from the European Respiratory Society/American Thoracic Society [13] make no mention of opportunities to reduce exacerbations through physical interventions to reduce the risk of acquiring respiratory viruses. A recent patient-clinician research prioritisation has identified better prevention of exacerbations as the top priority for COPD exacerbation research [14].…”

Section: Introductionmentioning

confidence: 99%

Reduction in COPD exacerbations during COVID-19: a systematic review and meta-analysis

Alqahtani

Oyelade²,

Aldhahir

et al. 2021

Preprint

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Background Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Seven studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.42-0.58). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index. Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period, associated with a reduction in respiratory viral infections that trigger exacerbations. We provide pooled evidence supporting the potential effectiveness of COVID-19 preventive interventions in reducing the risk of admissions for COPD exacerbations.

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Quality Standard Position Statements for Health System Policy Changes in Diagnosis and Management of COPD: A Global Perspective

Bhutani

Price

Winders³

et al. 2022

Adv Ther

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Introduction Despite being a leading cause of death worldwide, chronic obstructive pulmonary disease (COPD) is underdiagnosed and underprioritized within healthcare systems. Existing healthcare policies should be revisited to include COPD prevention and management as a global priority. Here, we propose and describe health system quality standard position statements that should be implemented as a consistent standard of care for patients with COPD. Methods A multidisciplinary group of clinicians with expertise in COPD management together with patient advocates from eight countries participated in a quality standards review meeting convened in April 2021. The principal objective was to achieve consensus on global health system priorities to ensure consistent standards of care for COPD. These quality standard position statements were either evidence-based or reflected the combined views of the panel. Results On the basis of discussions, the experts adopted five quality standard position statements, including the rationale for their inclusion, supporting clinical evidence, and essential criteria for quality metrics. These quality standard position statements emphasize the core elements of COPD care, including (1) diagnosis, (2) adequate patient and caregiver education, (3) access to medical and nonmedical treatments aligned with the latest evidence-based recommendations and appropriate management by a respiratory specialist when required, (4) appropriate management of acute COPD exacerbations, and (5) regular patient and caregiver follow-up for care plan reviews. Conclusions These practical quality standards may be applicable to and implemented at both local and national levels. While universally applicable to the core elements of appropriate COPD care, they can be adapted to consider differences in healthcare resources and priorities, organizational structure, and care delivery capabilities of individual healthcare systems. We encourage the adoption of these global quality standards by policymakers and healthcare practitioners alike to inform national and regional health system policy revisions to improve the quality and consistency of COPD care worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02137-x.

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Research priorities for exacerbations of COPD

Cited by 35 publications

References 0 publications

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Reduction in COPD exacerbations during COVID-19: a systematic review and meta-analysis

Quality Standard Position Statements for Health System Policy Changes in Diagnosis and Management of COPD: A Global Perspective

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