Medicine and Health Sciences Commons^™

Copd Discharge Care Bundles: An Integrative Review, Leigh Goodwin Wingo

Doctoral Dissertations and Projects

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the United States. It is the reason for millions of emergency room and hospitalizations, increasing healthcare costs, morbidity, and mortality. Many studies have evaluated the effects of COPD patient care bundles to help reduce the risk of 30-60-90-day readmissions post discharge from the hospital for COPD exacerbation. A comprehensive search was conducted on articles dated between February 2015 to January 2020 in the MEDLINE, EMBASE, and CINAHL, OVID, internet search, and Liberty University online library. This review included articles based on the effectiveness of COPD discharge …

Letter To Editor Regarding The Ocean Study, Barbara P. Yawn, Barry Make, David M. Mannino, Fernando J. Martinez, Meilan K. Han

Preventive Medicine and Environmental Health Faculty Publications

No abstract provided.

Chronic Obstructive Pulmonary Disease, Aaron Mcneilan

Nursing Student Class Projects (Formerly MSN)

The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.

Copd Topic Discussion, Clarice Resso, Pharmd, Farzana Tarannum, Pharmd

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Food Insecure Copd Patients And Healthcare Utilization: A Retrospective Study, Kristine Mendoza

Dissertations

Abstract

Purposes/Aims: Despite advances in the recognition and treatment of high-cost users of health care, the incidence of healthcare utilization remains high. Rates of hospital admissions and emergency room visits among chronic disease like COPD have become a targeted group for health management. COPD patients have multiple and complex health and social needs, but the impact of their unmet food needs is not well understood and warrants further investigation. The purpose of this study is to explore the relationships between COPD food insecure patients and healthcare utilization in San Diego County.

Background/Rationale: Government programs targeting patients with high healthcare costs …

Impact Of Dietary Fiber And Omega6/3 Intake On Copd Outcomes In U.S. Adults, Jacey Hain

Capstone Experience

COPD is the 4^th leading cause of death in the United States and is the leading cause of hospitalizations in adults.¹Although there is no cure for COPD, symptoms can be managed to increase the quality of life of those affected by the disease. Dietary omega-3 and -6 as well as fiber intakes have been noted as mitigating the burden of disease through their anti-inflammatory properties. We set out to look at the synergistic effect of both omega-3,-6, -6:-3 ratio and fiber on COPD, lung function and respiratory morbidities. We used data from the National Heath and Nutritional …

Informing The Pathway Of Copd Treatment (Impact) Trial: Fibrinogen Levels Predict Risk Of Moderate Or Severe Exacerbations, Dave Singh, Gerard J. Criner, Mark T. Dransfield, David M. G. Halpin, Meilan K. Han, Peter Lange, Sally Lettis, David A. Lipson, David M. Mannino, Neil Martin, Fernando J. Martinez, Bruce E. Miller, Robert Wise, Chang-Qing Zhu, David Lomas

Preventive Medicine and Environmental Health Faculty Publications

Background: Fibrinogen is the frst qualifed prognostic/predictive biomarker for exacerbations in patients with chronic obstructive pulmonary disease (COPD). The IMPACT trial investigated futicasone furoate/umeclidinium/ vilanterol (FF/UMEC/VI) triple therapy versus FF/VI and UMEC/VI in patients with symptomatic COPD at risk of exacer‑ bations. This analysis used IMPACT trial data to examine the relationship between fbrinogen levels and exacerbation outcomes in patients with COPD.

Methods: 8094 patients with a fbrinogen assessment at Week 16 were included, baseline fbrinogen data were not measured. Post hoc analyses were performed by fbrinogen quartiles and by 3.5 g/L threshold. Endpoints included on-treatment exacerbations and adverse events …

Addressing Comorbidity Education Needs In Tristar Skyline’S Readmission Reduction Program, Savannah Carroll

OTD Capstone Projects

This doctoral capstone experience was completed in partnership with TriStar Skyline Medical Center’s inpatient rehabilitation Readmission Reduction Program. This project was driven by a need to increase the provision of education for patients qualifying for this program to promote successful comorbidity management upon discharge to reduce avoidable readmissions. The primary focus of this project was to develop educational materials to promote an understanding of how to successfully manage Diabetes Mellitus, COPD, and CHF to reduce disease complications and avoidable readmissions. The educational materials were developed as online interactive modules for in-room education at the patient’s own pace with voice over …

Effects Of Fenoterol/Ipratropium Bromide On Fev1 And Hyperinflation In Thai Copd Patients, Kamon Kawkitinarong, Anan Ananpipatkul, Nareerat Sae-Eao, Thanin Asawawichienchinda, Worawan Sirichana

Chulalongkorn Medical Journal

Background: Patients with chronic obstructive pulmonary disease (COPD) usually suffer from breathlessness caused by chronic progressive worsening of airway obstruction and lung hyperinflation. Objective: This study aimed to evaluate the effects of fenoterol hydrobromide and ipratropium bromide combination on lung function parameters in Thai COPD patients. We also compared the effects from two commercially available products; Aerobidol® metered-dose inhaler (MDI) and Berodual® inhaler. Methods: A double-blind, randomized cross-over study was conducted in 31 COPD patients from outpatient service, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. To compare the responses of both inhalers on lung volume parameters, patients were randomized to be …

Reduction Of Hospital Readmissions In Patients With A Diagnosis Of Copd: An Integrative Review, Guerline Norbrun

Doctoral Dissertations and Projects

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease with potential to interfere with breathing ability. It is the third leading cause of 30-day readmission and death in the US, and the leading cause of mortality and morbidity worldwide. It constitutes a society burden and poor disease management leads to major health consequences such as acute COPD exacerbation resulting in frequent costly readmissions, add to its massive direct healthcare costs. Over $50 billion are spent annually in direct care alone in addition to $15 billion in hospital readmissions; with 12 million adults are being affected in the United States …

Anti-Inflammatory Effects Of Α7-Nicotinic Ach Receptors Are Exerted Through Interactions With Adenylyl Cyclase-6, Simeng Zhu, Shiqian Huang, Guofang Xia, Jin Wu, Yan Shen, Ying Wang, Rennolds S. Ostrom, Ailian Du, Chengxing Shen, Congfeng Xu

Pharmacy Faculty Articles and Research

Background and purpose

Alpha 7 nicotinic acetylcholine receptors (CHRNA7) suppress inflammation through diverse pathways in immune cells, so is potentially involved in a number of inflammatory diseases. However, the detailed mechanisms underlying CHRNA7’s anti‐inflammatory effects remain elusive.

Experimental approach

The anti‐inflammatory effects of CHRNA7 agonists in both murine macrophages (RAW 264.7) and bone marrow‐derived macrophages (BMDM) stimulated with LPS were examined. The role of adenylyl cyclase 6 (AC6) in Toll‐like Receptor 4 (TLR4) degradation was explored via overexpression and knockdown. A mouse model of chronic obstructive pulmonary disease was used to confirm key findings.

Results

Anti‐inflammatory effects of CHRNA7 were …

Gold In Practice: Chronic Obstructive Pulmonary Disease Treatment And Management In The Primary Care Setting, Barbara P. Yawn, Matthew L. Mintz, Dennis E. Doherty

Internal Medicine Faculty Publications

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Early detection and appropriate treatment and management of COPD can lower morbidity and perhaps mortality. Clinicians in the primary care setting provide the majority of COPD care and are pivotal in the diagnosis and management of COPD. In this review, we provide an overview of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, with a focus on the management of COPD in the primary care setting. We discuss the pathophysiology of COPD; describe COPD risk factors, signs, and symptoms that may facilitate earlier diagnosis …

Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this research was to explore why some African American men diagnosed with chronic obstructive pulmonary disease (COPD) continue smoking following their diagnosis. The theory of planned behavior (TPB) guided the development of this research. The research questions were developed to understand the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control that influence their continuing or quitting smoking based on the TPB model. The study’s research method was qualitative. A pilot study, using the same criteria as the main study, confirmed the reliability of the interview guide. Participants were informed about the study …

Pulmonary Rehabilitation And Hospital Readmissions Among Individuals With Chronic Obstructive Pulmonary Disease, Nicholas Prush

Walden Dissertations and Doctoral Studies

Due to policies that penalize hospitals for chronic obstructive pulmonary disease (COPD) readmissions and the health problems faced by individuals who are readmitted due to COPD, it is critical to identify treatments and strategies that can help reduce the likelihood of readmission. The purpose of this study was to assess the association of pulmonary rehabilitation and demographic variables (age, gender, and BMI) on 30-day hospital readmissions for patients with COPD. Shearer’s health empowerment theory was the theoretical framework for this quantitative study. Secondary data were obtained from a hospital and the sample was comprised of 253 COPD patients admitted between …

Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis

Walden Dissertations and Doctoral Studies

AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. …

Psychosocial Factors And Physical Health In Chronic Obstructive Pulmonary Disease Patients, Olulana Bamiro

Walden Dissertations and Doctoral Studies

The research problem identified was poor physical health in older adults with chronic obstructive pulmonary disease (COPD). The problem is important because poor physical health yields unsuccessful aging. The current research aimed to identify psychosocial factors that improve self-evaluated physical health in the study population as a proxy to overall health; the research questions helped identify these factors. The first research question assessed the association between health locus of control and self-evaluated physical health. The second research question evaluated the association between family support and self-evaluated physical health. A final research question assessed the association between health locus of control, …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Differences In Smoking Behaviors And Readiness To Change For Patients With Copd And Differing Categories Of Depression, Jessica M. Floyd

Graduate Theses, Dissertations, and Problem Reports

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Depression is a common comorbidity of COPD and affects patient outcomes and smoking cessation. The purpose of this study was to explore and describe factors influencing smoking behaviors and readiness to change in patients with comorbid COPD and depression.

Aims: The research question that guided this study was, “What are the relationships among smoking, COPD, and depression?” The following aims stemmed from the research question: to describe the characteristics of a convenience sample of people living with COPD and differing categories of depression who …

Feasibility, Tolerance And Effects Of Adding Impact Loading Exercise To Pulmonary Rehabilitation In People With Chronic Obstructive Pulmonary Disease: Study Protocol For A Pilot Randomised Controlled Trial, Erin Cecins, Kylie Hill, Dennis R. Taaffe, David Manners, Anne-Marie Hill, Robert U. Newton, Daniel A. Galvão, Vinicius Cavalheri

Research outputs 2014 to 2021

Background:

Chronic obstructive pulmonary disease (COPD) is a disorder linked with a multitude of extra pulmonary manifestations (also known as treatable traits), including low bone mineral density (BMD). To date, no specific guidelines exist for the management of BMD in this population. Impact loading exercise has been identified as an intervention that improves or maintains BMD in other populations. However, the feasibility of and tolerance to impact loading exercise has not been tested in people with COPD. The aim of the proposed study will be to investigate the feasibility and tolerance of adding impact loading exercise to a standard pulmonary …

Standardisation Of Clinical Assessment, Management And Follow-Up Of Acute Hospitalised Exacerbation Of Copd: A Europe-Wide Consensus, Sanjay Ramakrishnan, Wim Janssens, Pierre R. Burgel, Marco Contoli, Frits M. E. Franssen, Neil J. Greening, Timm Greulich, Iwein Gyselinck, Andreas Halner, Arturo Huerta, Rebecca L. Morgan, Jennifer K. Quint, Lowie E. G. W. Vanfleteren, Kristina Vermeersch, Henrik Watz, Mona Bafadhel

Research outputs 2014 to 2021

Background: Despite hospitalization for exacerbation being a high-risk event for morbidity and mortality, there is little consensus globally regarding the assessment and management of hospitalised exacerbations of COPD. We aimed to establish a consensus list of symptoms, physiological measures, clinical scores, patient questionnaires and investigations to be obtained at time of hospitalised COPD exacerbation and follow-up. Methods: A modified Delphi online survey with pre-defined consensus of importance, feasibility and frequency of measures at hospitalisation and follow-up of a COPD exacerbation was undertaken. Findings: A total of 25 COPD experts from 18 countries contributed to all 3 rounds of the survey. …

Multidrug-Resistance, Antibiotic-Associated Acute Kidney Injury, And Poor Disease Prognosis In Community-Acquired Bacterial Pneumonia, Adeniyi J. Idigo

All ETDs from UAB

In this dissertation research, I examined the challenges of treating patients with bacterial community-acquired pneumonia (CAP) with the purpose of identifying risk factors linked with multidrug-resistant (MDR) Pseudomonas, treatment toxicity, and poor disease prognosis. I used a retrospective cohort study design to explore a clinical cohort of patients admitted to the University of Alabama at Birmingham hospital network who had bacterial pneumonia diagnosis assessed to be from community transmission between January 2013-December 2019. Electronic medical records were accessed for socio-demographic and clinical information. First, I examined the local prevalence/incidence of Pseudomonas CAP and MDR Pseudomonas CAP, and the relationship between …

Maintenance Of Pulmonary Rehabilitation Benefits In Patients With Copd: Is A Structured5-Year Follow-Up Program Helpful?, İpek Candemi̇r, Pinar Ergün, Mustafa Engi̇n Şahi̇n

Turkish Journal of Medical Sciences

Background/aim: Pulmonary rehabilitation (PR) has proven useful in patients with chronic obstructive pulmonary disease (COPD), but the benefits decrease over time. We evaluated the effects of a structured follow-up program after PR on patient pulmonary function, dyspnea, body composition, exercise capacity, quality of life, psychological status, i-BODE index, hospitalization status, 5-year survival rate. We explored whether this follow-up program could serve as a maintenance program. Materials and methods: COPD patients who completed PR attended follow-up visits over 5 years. We administered incremental (ISWT), endurance shuttle walk tests (ESWT), measured body (BMI), fat-free mass indices (FFMI), recorded modified Medical Research Council …