Abstract:
OBJECTIVE:To examine medication adherence and persistence among COPD patients during their last year of life. DATA SOURCE:National VA databases were used to identify patients who had COPD and died between 1999 and 2003. STUDY DESIGN:We examined use of inhaled corticosteroids (ICS), long acting beta(2) agonists (LABA), methylxanthines (MTX), and anticholinergics (AC), alone and in combination. Medication possession ratios (MPR) were compared between regimens by quarterly periods using General Estimating Equations (GEE). Medication persistence was examined in monotherapy users with Kaplan-Meier survival analysis and extended Cox proportional hazard models. PRINCIPAL FINDINGS:Only half of the identified patients in the COPD cohort (5913 of 11,376) used any medications. Among 5913 patients, overall mean (SD) MPR was 0.44 (0.32) during the last year of life. A positive linear trend in MPR was observed across quarterly periods in AC users (beta=0.014, p<0.0001), and was highest for MTX users (beta=0.11, p<0.0001). Of 3436 on monotherapy only, 40% discontinued medication within 30 days, and 70% discontinued within 90 days. MTX users were less likely to discontinue (HR=0.714, p=0.012) than reference (AC) group. CONCLUSION:COPD patients in their last year of life tended to use respiratory medications sporadically. Further research is needed to qualify whether minor differences in MPR between regimens reflect behavioral differences related to regimen or reflect refill policy and MPR calculation technique.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Jung E,Pickard AS,Salmon JW,Bartle B,Lee TAdoi
10.1016/j.rmed.2008.11.004subject
Has Abstractpub_date
2009-04-01 00:00:00pages
525-34issue
4eissn
0954-6111issn
1532-3064pii
S0954-6111(08)00397-1journal_volume
103pub_type
杂志文章abstract:BACKGROUND:The 6-min walk test (6MWT) is a submaximal exercise test used to assess functional status in patients with cardiopulmonary diseases. Regression equations have previously been published as a normal reference for 6-min walk distance (6MWD) in healthy Caucasian adults. However, a recent study showed that the no...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2009.01.012
更新日期:2009-07-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.02.024
更新日期:2007-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1053/rmed.2002.1342
更新日期:2002-07-01 00:00:00
abstract:INTRODUCTION:Combination inhaled corticosteroid/long-acting bronchodilator (ICS/LABA) therapy reduces the exacerbation rate and improves spirometry and quality of life in COPD. We hypothesized that ICS/LABA therapy also improves small airway function measured by FOT. METHODS:14 subjects with COPD were commenced on com...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2013.10.004
更新日期:2014-02-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.04.021
更新日期:2019-06-01 00:00:00
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pub_type: 杂志文章
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journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2010-09-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2008.09.009
更新日期:2009-02-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rmed.2001.1055
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Anti-CADM-140 antibody (anti-CADM-140), also referred to as anti-melanoma differentiation-associated gene 5 (MDA5) antibody, is a myositis-specific antibody identified in the sera of patients with clinically amyopathic dermatomyositis (C-ADM) and is associated with a worse prognosis in dermatomyositis-associ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2011.05.006
更新日期:2011-09-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章
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更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) are responsible for a high utilisation of the health care resources, and the cost is expected to increase. Physiological measures of lung function often fail to describe the impact the symptoms have on exacerbations, days of hospitalisation, and on a...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2006.09.020
更新日期:2007-05-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2007.05.006
更新日期:2007-10-01 00:00:00
abstract::This retrospective study reviews the patterns of P. cepacia pulmonary infection in 75 of a total of 872 mainly adults with cystic fibrosis, registered here during the 4 years 1987-1990; 35 (47%) were female. During this period, 55 patients acquired P. cepacia and the annual incidence and prevalence rates have remained...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/0954-6111(93)90090-m
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Exhaled breath condensate (EBC) is simple to collect and as such a non-invasive method that has attracted substantial interest in the last few years. However, several methodological concerns have been raised and it has been difficult to reproduce results between different centres. Because of low concentratio...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.04.007
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Although smoking cessation is strongly indicated by international guidelines as an effective therapeutic tool for patients with COPD and Asthma, a large proportion of them do not quit smoking and they are regarded as a "difficult" target group. AIM:To study the effectiveness of an intensive smoking cessat...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2014.01.007
更新日期:2014-04-01 00:00:00
abstract::Capsaicin has long been known to act selectively on a subpopulation of neurons to produce initial excitation, followed by a prolonged neuroinhibitory action commonly referred to as 'capsaicin desensitization'. This property has been exploited extensively as a tool with which to investigate the role of these nerves in ...
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更新日期:1991-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2020.105919
更新日期:2020-01-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章,评审
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更新日期:1993-02-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rmed.2000.0959
更新日期:2000-12-01 00:00:00
abstract:INTRODUCTION:Dental caries and respiratory tract infections are among the most common infectious diseases worldwide and they both are appearing in the respiratory system. However, their relations are still unclear. This study investigated the association of dental caries on the risk of lower respiratory tract infection...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.09.002
更新日期:2019-01-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.02.006
更新日期:2005-08-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2012.11.018
更新日期:2013-03-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2014.05.011
更新日期:2014-08-01 00:00:00
abstract::The N(2) slope is an index of inhomogeneous distribution of ventilation and has been suggested to be suited for early testing of chronic obstructive pulmonary disease (COPD) in smokers. The aim of the present study was to examine the association between the fraction of exhaled nitric oxide (FENO) and the N(2) slope in...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.09.037
更新日期:2006-06-01 00:00:00
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journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.1999.0746
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To assess the utility of capsaicin test in the differential diagnosis of non-productive causes of chronic cough and to examine the effects of treatment on this reflex. PARTICIPANTS:86 healthy volunteers and 101 patients with chronic cough: asthma (n: 54) gastroesophageal reflux (n: 35) and post-nasal drip s...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章
doi:10.1053/rmed.2002.1460
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Smoking continues to be a major risk factor for COPD and may impact the efficacy of COPD treatments, with guidelines supporting the crucial importance for current smokers of smoking cessation. A post-hoc analysis of the FLIGHT1 and FLIGHT2 studies assessed the impact of smoking status on the efficacy and saf...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.07.019
更新日期:2019-08-01 00:00:00