Primary care respiratory journal : journal of the General Practice Airways Group
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Randomized Controlled Trial
A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO.
We have developed a winter forecasting service to predict when patients with COPD are at higher risk of an exacerbation and alert them via an automated telephone call. ⋯ The ability of the forecast to predict high risk periods was confirmed unequivocally. Alert calls appeared to reduce the frequency and severity of exacerbations but these effects did not reach statistical significance, perhaps because of the number of participants, lower than expected exacerbation rates, and the fact that there was contact with patients in both groups whenever they appeared to be exacerbating.
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Randomized Controlled Trial Multicenter Study
Bronchodilator efficacy of tiotropium in patients with mild to moderate COPD.
Evaluation of tiotropium efficacy in patients with mild chronic obstructive pulmonary disease (COPD) defined by the 2003 Swedish Society of Respiratory Medicine guidelines (post-bronchodilator FEV1/FVC <70%; FEV1 >60% predicted). ⋯ Compared with placebo, tiotropium improved lung function in patients with mild COPD.
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Randomized Controlled Trial
COPD screening efforts in primary care: what is the yield?
Underdiagnosis of COPD appears to be common, although the degree of underdiagnosis is rarely measured. To document the extent of underdiagnosis in a high risk group of ambulatory patients, we performed spirometry in smokers aged 40 years and over drawn from general practices in two countries. ⋯ Screening of smokers over 40 in general practice may yield 10 - 20% undiagnosed COPD cases, with a substantial proportion of these having moderate to severe disease. Earlier diagnosis through targeted case-finding will allow early, aggressive smoking cessation efforts and may lead to a reduction in the burden of COPD symptoms and a reduced impact of the disease on health-related quality of life in these patients.