Understanding Practice Patterns of COPD: A Survey of Physicians in Nepal, Sri Lanka and Malaysia

Chokhani, Ramesh; Muttalif, Abdul Razak; Gunasekera, Kirthi; Mukhopadhyay, Aniruddha; Gaur, Vaibhav; Gogtay, Jaideep

doi:10.1007/s41030-021-00153-w

Cited by 4 publications

(6 citation statements)

References 42 publications

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“…We found that seventy three percent of the respondents think inhaler therapy as the first line therapy for managing COPD while Chokhani et al reported 54 percent of the physicians prescribe inhaler therapy to all COPD patients. 4 It was found that only twenty three percent of the respondents used to check the technique of the use of inhaler devices during follow up which was similar to Chokhani's another study in which 39.95% of the physicians evaluated their patients' inhalation technique on every visit. 4 Forty one percent of the respondents said that they told the method of inhalation technique while prescribing the inhalation therapy.…”

Section: Discussionsupporting

confidence: 56%

“…[1][2][3] The practice of inhaler therapy varies among different treating physicians in different part of the world. 4 The patients can be appropriately instructed only if the health care providers themselves are well trained to do so. 5 Different studies have shown that there is inadequate knowledge of the inhaler therapy among the patients, and also the health care workers including nurses who themselves teach the patients.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal

Dev Shrestha,

Dhungana,

Shrestha

et al. 2022

Nep. Resp. J.

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Introduction: Inhalation therapy is the administration of the aerosolized medication directly into the lungs and it is the most effective form of management of the obstructive airway disease including chronic obstructive airway disease, asthma and overlap syndrome. There is less data on the knowledge of inhaler therapy among the junior doctors who are managing obstructive airway disease at the first contact point. This study was done to assess the knowledge of undergraduate doctors and resident doctors who are treating the patients before the consultation with senior consultants working in one of the tertiary care hospital . The findings of the study will help find the strategies of filling the gaps of the knowledge of inhalation therapy among junior doctors while managing obstructive airway disease Objective: The primary objective of the study was to find the Knowledge of Inhaler Therapy among Undergraduates and Resident doctors in Bir Hospital. Methods: The study was a cross sectional questionnaire based descriptive study conducted in Bir Hospital, National Academy of medical Sciences. The study included purposeful sampling of the medical officers and residents working in medical ward and emergency. Results: Out of 70 respondents, 79% and 82% percent responded the correct method of the administration of the DPIs and MDIs respectively. Forty percent of the respondents had heard of the breath actuated devices and 88% of the respondents had heard of the spacer device. Forty one percent of the respondents said they teach the patients about the method of inhalation technique while prescribing the inhalation therapy. Seventy three percent of the respondents thought inhaler therapy as the first line therapy for managing COPD and Asthma. Conclusion: Prescription of inhalers, knowledge among junior MBBS undergraduate doctors regarding inhalation therapy, and correct use of inhalers varied, and was generally inadequate. More effort, academic training and exposure is needed to change the attitude of medical officers and residents regarding the concept of inhalation therapy.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal

Dev Shrestha,

Dhungana,

Shrestha

et al. 2022

Nep. Resp. J.

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“…In equation (1) , E i, j is the observed change from baseline in pre-dose (trough) FEV 1 (L) at the time point j in the i th arm, and E max,i represents the maximal change from baseline in trough FEV 1 (L) in the i th arm. τ i is the loss of efficacy rate in the i th arm, while ε i, j is the residual error at the time point j in the i th arm, which is weighted by the inverse of the square root of the sample size ( N i, j ), assumed to be normally distributed, with a mean of 0 and variance of σ 2 . The residual errors are smaller in the arm with larger sample sizes.…”

Section: Methodsmentioning

confidence: 99%

“…η 1, i and η 2, i represent the interstudy variability of E max and τ , respectively. E max and τ are assumed to be normally distributed, with means of 0 and variances of ω 1 2 and ω 2 2 .…”

Section: Methodsmentioning

confidence: 99%

“…According to a prediction by the World Health Organization (WHO), the prevalence of COPD will continue to rise in the next 40 years, and the annual number of deaths caused by this disease and associated diseases will exceed 5.4 million by 2060. 1,2 The goals in the management of COPD are to prevent deterioration of lung function and to reduce symptoms as well as the frequency and severity of exacerbations. 3 The current guidelines recommend the use of longacting bigeminal therapy, mainly LABA/LAMA fixed-dose combinations (FDCs) and LABA/ICS FDCs, for the treatment of COPD.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative analysis of efficacy and safety of LABA/LAMA fixed-dose combinations in the treatment of stable COPD

Gong

Liu

et al. 2022

Ther Adv Respir Dis

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Objective: This study aimed to quantitatively compare the efficacy and safety of long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combinations (FDCs) for the treatment of stable chronic obstructive pulmonary disease (COPD), especially in terms of their loss of efficacy in lung function. Methods: Randomized controlled clinical trials of LABA/LAMA FDCs for the treatment of stable COPD were comprehensively searched for in public databases. Pharmacodynamic models were established to describe the time course of the primary outcome [trough forced expiratory volume in the first second (FEV1)]. Secondary outcomes [COPD exacerbations, St. George’s Respiratory Questionnaire (SGRQ), Transition Dyspnoea Index (TDI), and rescue medication use] and safety outcomes [mortality, serious adverse events (SAEs), and withdrawals due to adverse events (AEs)] were also compared via a meta-analysis. Results: A total of 22 studies involving 16,486 participants were included in this study. The results showed that in terms of primary outcome (change from baseline in trough FEV1), the efficacy of vilanterol/umeclidinium was the highest, while the efficacy of formoterol/aclidinium was the lowest, with a maximum effect value (Emax) of 0.185 L [95% confidence interval (CI): 0.173–0.197 L] and 0.119 L (95% CI: 0.103–0.135 L), respectively. The efficacy of other drugs, such as formoterol/glycopyrronium, indacaterol/glycopyrronium, and olodaterol/tiotropium, were comparable, and their Emax values were 0.150–0.177 L. Except for vilanterol/umeclidinium, the other four LABA/LAMA FDCs showed a certain degree of loss of efficacy. Compared with the efficacy at 2 days, the trough FEV1 (L) relative to baseline at 24 weeks decreased by 0.029–0.041 L. In terms of secondary outcomes, the efficacy of different LABA/LAMA FDCs was similar in TDI and rescue medication use. However, formoterol/aclidinium was better in preventing the COPD exacerbations, while vilanterol/umeclidinium was the best in terms of SGRQ. In addition, different LABA/LAMA FDCs and placebo had similar safety outcomes. Conclusion: The present findings may provide necessary quantitative information for COPD medication guidelines.

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Awareness of COPD in low-and middle-income countries and implications for treatment

Ghorpade,

Salvi

2024

Expert Review of Respiratory Medicine

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Understanding Practice Patterns of COPD: A Survey of Physicians in Nepal, Sri Lanka and Malaysia

Cited by 4 publications

References 42 publications

Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal

Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal

Quantitative analysis of efficacy and safety of LABA/LAMA fixed-dose combinations in the treatment of stable COPD

Awareness of COPD in low-and middle-income countries and implications for treatment

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