Abstract:
BACKGROUND AND OBJECTIVE:The implementation of chronic obstructive pulmonary disease (COPD) guidelines in the real-world setting remains low. Pulmonologists should participate in the new paradigms of chronicity of COPD, by providing their knowledge, expertise, innovation and research. The objective of this study was to survey pulmonologists on the adherence to COPD guidelines and to measure the change of attitude after holding meetings presenting the latest research on the subject. METHODS:Fifty questions on COPD management were sent to 150 pulmonologists. Using the AUDIT methodology, the responses were discussed at several face-to-face meetings, held in different autonomous communities of Spain. The same questionnaire was subsequently sent to the participants and changes in their responses were analysed. RESULTS:In total, 148 physicians (60.1% female) completed study. The main responses were: (1) 16.2% diagnose following clinical criteria; (2) 78.4% performed diagnostic tests other than spirometry; (3) 73.6% always determined alpha-1 antitrypsin levels (81.8% in the second questionnaire, p < 0.05); (4) 73% determined the patient's phenotype; (5) 42% always asked about passive exposure to cigarette smoke (55% after the meetings, p < 0.05); (6) 58.1% always asked about exposure to other pollutants or biomass; (7) 29.1% always assessed inhalational technique; (8) dual bronchodilators were the most common treatment (49.3%) used for patients with frequent exacerbator phenotype, glycopyrronium + indacaterol being the preferred option (44.1%); (9) 41.2% discontinued inhaled corticosteroids treatment (54.7% in the second questionnaire, p < 0.05); (10) for exacerbation admissions, 52% replaced maintenance bronchodilators with short-acting agents and introduced early background treatment (58.8% in the second round, p < 0.05). Few variations occurred in the participants' answers after the meetings. CONCLUSIONS:The adherence of pulmonologists to clinical practice recommendations for COPD management is suboptimal. As well as face-to-face meetings, more intensive interventions are required to raise awareness on the importance of improving compliance with clinical guidelines.
journal_name
Clin Drug Investigjournal_title
Clinical drug investigationauthors
de Miguel-Díez J,Jiménez-García R,López de Andrés A,Zaragoza Arnáez Fdoi
10.1007/s40261-019-00787-4subject
Has Abstractpub_date
2019-07-01 00:00:00pages
653-664issue
7eissn
1173-2563issn
1179-1918pii
10.1007/s40261-019-00787-4journal_volume
39pub_type
杂志文章abstract:OBJECTIVE:To investigate the efficacy and tolerability of high-dose N-acetylcysteine (NAC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (COPD). DESIGN AND PATIENTS:Randomised, double-blind, double-dummy, placebo-controlled study in 123 patients experiencing an acute exacerba...
journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.2165/00044011-200525060-00005
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The possible adverse or positive effects of levothyroxine treatment among patients with atrial fibrillation have been debated. Atrial fibrillation, levothyroxine treatment, and dementia are common among older adults, yet little is known about the effects of levothyroxine on the development of d...
journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.1007/s40261-018-0740-3
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:The management of advanced gastrointestinal stromal tumors (GISTs) has been modified considerably by the availability of costly tyrosine kinase inhibitors (TKIs); however, the best therapeutic sequence in terms of cost and effectiveness remains unknown. OBJECTIVE:The aim of this study was to compare four ...
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doi:10.1007/s40261-016-0463-2
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Addressing the needs of migraineurs by actively seeking patient feedback on disease-related disability and treatment satisfaction may lead to improved management and treatment outcomes. Patient feedback can be collected in postmarketing surveillance (PMS) studies. The objective of this PMS study was to evalua...
journal_title:Clinical drug investigation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.2165/00044011-200727010-00005
更新日期:2007-01-01 00:00:00
abstract::Opioids are the most powerful analgesic drugs currently available and consequently form an essential part of the treatment options for malignant and non-malignant chronic pain. However, the benefits of these medications can be offset by gastrointestinal adverse events such as nausea, vomiting and constipation, as well...
journal_title:Clinical drug investigation
pub_type: 杂志文章,评审
doi:10.1007/BF03256935
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abstract:BACKGROUND:Post-marketing surveillance studies can provide supplemental data on the safety of medications in the general population. OBJECTIVE:This study aimed to evaluate the safety of analgesic regimens including the NSAID lornoxicam in the short-term treatment of postoperative pain in a clinically relevant populati...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2165/11538860-000000000-00000
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abstract:INTRODUCTION:More and more evidence suggests that the density of calcification plays an important role in the plaque stability. However, few studies have investigated the statin treatment on the density of plaque calcification in patients with both coronary artery disease (CAD) and type 2 diabetes mellitus. METHODS:On...
journal_title:Clinical drug investigation
pub_type: 临床试验,杂志文章
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更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The efficacy and tolerability of acarbose were examined in a postmarketing surveillance study of 27 803 patients with diabetes mellitus (26 044 were diagnosed as having type 2 diabetes) over a 12-week treatment period. PATIENTS AND M ethods: Overall efficacy data were reported for type 1 and type 2 diabetes, ...
journal_title:Clinical drug investigation
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doi:10.2165/00044011-200525100-00004
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abstract:BACKGROUND AND OBJECTIVE:TZP-101 is a selective, small molecule ghrelin receptor agonist in clinical development for the treatment of gastric motility disorders. The objectives of this study was to assess pharmacokinetic parameters of TZP-101 after multiple- and single-dose administration to healthy subjects and patien...
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pub_type: 杂志文章,随机对照试验
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更新日期:2009-01-01 00:00:00
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更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2165/00044011-200929070-00001
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultra-long-acting insulin degludec (DEG) has a longer duration of action and less daily variability relative to other basal insulin (BI), and thus may benefit patients with type 1 diabetes mellitus (T1DM). We examined the impact of switching BI to DEG on glycemic control and insulin dose in T1...
journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.1007/s40261-017-0541-0
更新日期:2017-09-01 00:00:00
abstract::West syndrome (WS), also known as infantile spasms, occurs in infancy with a peak between 4 and 7 months. Spasms, neurodevelopmental regression and hypsarrhythmia on electroencephalogram (EEG) basically define WS. The International League Against Epilepsy commission classifies the aetiologies of WS into genetic, struc...
journal_title:Clinical drug investigation
pub_type: 杂志文章,评审
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更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Oxycodone tamper resistant (OTR) is a new extended-release abuse-deterrent formulation providing improvements in the tamper resistant characteristics. This study aimed to investigate the pharmacokinetic properties of the new OTR tablets and evaluate the bioequivalence of oxycodone from OTR and...
journal_title:Clinical drug investigation
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40261-019-00870-w
更新日期:2020-02-01 00:00:00
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journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.2165/00044011-200020020-00003
更新日期:2000-01-01 00:00:00
abstract::This review focuses on previously unpublished clinical and pharmacokinetic data with the diclofenac epolamine (diclofenac hydroxyethylpyrrolidine) patch supporting the hypothesis of a topical effect of this formulation. Previous studies have shown that 1 or 2 weeks of treatment with diclofenac epolamine provides pain ...
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pub_type: 杂志文章,评审
doi:10.2165/0044011-200929010-00001
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Indacaterol is a novel, inhaled, once-daily, ultra-long-acting β2-adrenoceptor agonist that has been approved in the EU for the treatment of chronic obstructive pulmonary disease (COPD). Ethnic differences may influence the pharmacokinetics and pharmacodynamics of a drug, and it is therefore important to com...
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pub_type: 杂志文章,随机对照试验
doi:10.2165/11586520-000000000-00000
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The optimal choice for first- and second-line antiseizure medications for pediatric patients with convulsive status epilepticus remains ambiguous. The present study aimed to estimate the comparative effect on the efficacy and safety of different antiseizure medications in pediatric patients wit...
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pub_type:
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更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost effectiveness of subcutaneous interferon-beta-1a (IFNbeta-1a) 44mug three times weekly in relapsing-remitting multiple sclerosis (RRMS) using an econometric model. METHODS:Data on RRMS patients treated with IFNbeta-1a 22 or 44mug subcutaneously three times weekly or placebo for up to 4 y...
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pub_type: 杂志文章
doi:10.2165/00044011-200323090-00003
更新日期:2003-01-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2165/0044011-200828120-00004
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Currently evidence about clinical and demographic predictors of response to newer antidepressants such as duloxetine is limited. This study aimed to investigate whether a number of predictors, particularly co-morbid anxiety disorders and anxious depression, are associated with clinical improve...
journal_title:Clinical drug investigation
pub_type: 临床试验,杂志文章
doi:10.2165/11588800-000000000-00000
更新日期:2011-01-01 00:00:00
abstract::In an in vivo rat model of myocardial infarction, opioid receptor stimulation has been observed to result in a reduction in infarct size similar to that produced by ischaemic preconditioning. The ability of glibenclamide to abolish this effect suggests an involvement of the myocardial ATP-sensitive potassium (K(ATP)) ...
journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.2165/00044011-199815050-00009
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Several drugs may interact with levothyroxine and reduce its bioavailability. The aim of this study was to analyse the Italian general practice patients with hypothyroidism from 2002-2011, in terms of variation of thyroid-stimulating hormone (TSH) levels, number of levothyroxine prescriptions ...
journal_title:Clinical drug investigation
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doi:10.1007/s40261-015-0271-0
更新日期:2015-03-01 00:00:00
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journal_title:Clinical drug investigation
pub_type: 杂志文章
doi:10.2165/00044011-199816060-00005
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In England, the uptake of direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation has been slow and varied across different Clinical Commissioning Groups (CCGs). This study aimed to profile the prescribing of oral anticoagulants for stroke prevention in patients with atr...
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pub_type: 杂志文章
doi:10.1007/s40261-019-00763-y
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Muscle wasting is common and insidious in end-stage renal disease (ESRD). Loss of muscle quantity and quality reduces quality of life and increases mortality in ESRD patients. Additionally, secondary hyperparathyroidism (SHPT) causes muscle atrophy. Meanwhile, vitamin D, which is used for SHPT treatment, pla...
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更新日期:2013-11-01 00:00:00
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pub_type: 杂志文章
doi:10.2165/00044011-200929030-00004
更新日期:2009-01-01 00:00:00
abstract::Since the introduction of the first gadolinium-based contrast agent (GBCA) approximately 25 years ago, magnetic resonance imaging (MRI) using GBCAs has revolutionized diagnostic and follow-up imaging of pathological lesions, with clinical applications expanded to encompass almost all fields of medicine. Intravenous ga...
journal_title:Clinical drug investigation
pub_type: 杂志文章,评审
doi:10.1007/s40261-013-0066-0
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Schizophrenia treatment has been shifting to resocialization by efficacious antipsychotic drugs. However, even some of the pivotal studies of approved new antipsychotic drugs with proven efficacy had failed due to high placebo response. The aim of this study was to identify the potential factor...
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pub_type: 杂志文章,meta分析
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更新日期:2018-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The standard of care for HIV treatment is a three-drug regimen consisting of two nucleoside reverse transcriptase inhibitors (NRTIs) and either a non-nucleoside reverse transcriptase inhibitor, a protease inhibitor (PI) or an integrase strand transfer inhibitor. Darunavir boosted with ritonavi...
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更新日期:2017-01-01 00:00:00