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Appropriate use and withdrawal of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD)
Román-Rodríguez, M.; Tsiligianni, I.; Wiliams, S.; et al.
International Primary Care - Respiratory Group
(2020)
CC2
The document "Appropriate use and withdrawal of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD)" from the IPCRG provides guidance on when to start, adjust
...
, or discontinue ICS in COPD treatment. It highlights the benefits and risks, emphasizing personalized treatment based on patient history, exacerbation frequency, and eosinophil count, while detailing how to optimize bronchodilator use to manage symptoms effectively.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to
...
prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
The webpage from the Institute for Health Metrics and Evaluation (IHME) features a podcast discussing chronic respiratory diseases and their global impact. It highlights the growing burden of diseases such as
...
chronic obstructive pulmonary disease (COPD) and asthma worldwide. The podcast provides insights into the challenges faced in managing and preventing these diseases, emphasizing the importance of early diagnosis, public health strategies, and global data to inform healthcare policies. Experts discuss the role of environmental and lifestyle factors in disease prevalence and outline ways to mitigate these risks through improved healthcare and awareness.
more
The webpage provides detailed information about asbestosis, a lung disease caused by inhaling asbestos fibers. It outlines various asbestos-related diseases, including benign and malignant pleural conditions as well as lung cancer. Asbestosis is des
...
cribed as a diffuse fibrotic disease of lung tissue resulting from prolonged and intense exposure to asbestos fibers, progressing slowly over time. The page covers the causes, risk factors, and pathology of the disease, highlighting different types of asbestos fibers and their effects on the lungs. It also discusses symptoms, diagnostic procedures, and potential complications, such as the increased risk of lung cancer and mesothelioma. Preventive measures and recommendations for those affected are also included.
more
The article "The burden of chronic obstructive pulmonary disease and its attributable risk factors in the Middle East and North Africa region, 1990–2019" provides an analysis of the prevalence, mo
...
rtality, and disability-adjusted life-years (DALYs) due to COPD in the MENA region from 1990 to 2019. The study uses data from the Global Burden of Disease (GBD) 2019 and shows that while age-standardized death and DALY rates have decreased over 30 years, COPD remains a significant health issue, especially among older populations. The main risk factors identified are smoking, ambient particulate pollution, and occupational exposure. The research underscores the impact of socioeconomic factors and recommends targeted public health initiatives to reduce the burden.
more
The article from the European Respiratory Journal discusses the natural history of chronic obstructive pulmonary disease (COPD), emphasizing its increasing global impact on morbidity and mortality.
...
It highlights that while cigarette smoking is a primary risk factor, other influences such as environmental exposures and genetics also play significant roles. The article notes that lung function, measured by FEV1 (forced expiratory volume in one second), is a critical indicator of both diagnosis and prognosis. It further explores the impact of exacerbations, comorbidities, and systemic inflammation on disease progression and outcomes. The need for comprehensive patient management, which considers various comorbid conditions and inflammatory factors, is emphasized to improve clinical outcomes and reduce healthcare costs.
more
The objective of the BREATHE study was to estimate the regional prevalence of chronic obstructive pulmonary disease (COPD) symptoms within the general population in the Middle East/North Africa (MEN
...
A) region and to document risk factors, disease characteristics and management using a standardised methodology.
more
This guideline covers diagnosing and managing chronic obstructive pulmonary disease or COPD (which includes emphysema and chronic bronchitis) in pe
...
ople aged 16 and older. It aims to help people with COPD to receive a diagnosis earlier so that they can benefit from treatments to reduce symptoms, improve quality of life and keep them healthy for longer.
more
The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview of COPD prevalence, associated risk factor
...
s, and challenges in diagnosis and treatment across these regions. The study highlights smoking and environmental exposures, such as dust and pollution, as significant contributors to COPD. It also points out the gaps in awareness, healthcare infrastructure, and the availability of diagnostic tools, which hinder effective management of the disease. The authors emphasize the need for comprehensive public health strategies, education, and improved access to healthcare to address the COPD burden in these areas.
more
Cardiovascular Disease, Type 2 Diabetes, Cancer and COPD in adults
Ministry of Health and Social Welfare, Tanzania
Tanzania Diabetes Association; World Diabetes Foundation
(2013)
CC
Chronic Non Communicable Diseases. Case Management Desk Guide
Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and ne
...
rves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025
more
Global strategy for prevention, diagnosis and management of COPD: 2023 Report
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
(2023)
CC2
The GOLD 2023 report provides a comprehensive update on the global strategy for diagnosing, managing, and preventing chronic obstructive pulmonary disease (COPD). It emphasizes that COPD is a leadin
...
g cause of death worldwide, driven by risk factors such as tobacco smoking, air pollution, and genetic predispositions. The report outlines key updates, including new diagnostic criteria, the introduction of terms like "Pre-COPD" and "PRISm" for early identification, and expanded sections on comorbidities, pharmacological and non-pharmacological treatments, and rehabilitation. It stresses the importance of personalized treatment plans, early diagnosis, and addressing risk factors to mitigate the disease's impact. The report is aimed at guiding healthcare providers to improve COPD outcomes and adapt treatment approaches based on the latest evidence.
more
Updated recommendations on treatment of adolescents and children with chronic HCV infection
recommended
The new treatment recommendations that extend the 2018 treat all recommendation for adults with chronic HCV infection to include adolescents and children down to 3 years, and to align the existing recommended pangenotypic direct-acting antiviral (DA
...
A) regimens (SOF/DCV, SOF/VEL and G/P) for adults, to those for adolescents and children. This alignment is expected to simplify procurement, promote access to treatment among children in low- and middle-income countries and contribute to global efforts to eliminate the disease
more
The article investigates the diagnostic capabilities and prevalence of chronic obstructive pulmonary disease (COPD) in primary care settings in northern Brazil. It highlights that COPD is often unde
...
rdiagnosed and undertreated in resource-limited regions. The study involved 34 general practitioners and used spirometry to evaluate their diagnostic accuracy compared to clinical assessments. Findings revealed significant discrepancies between GP diagnoses and spirometry results, with many false positives and negatives. The study underscores the need for better training and the use of spirometry to improve COPD diagnosis and case-finding in primary care, emphasizing the importance of targeted strategies to enhance healthcare outcomes in developing countries.
more
Chronic obstructive pulmonary disease (COPD) is an increasingly important cause of morbidity, disability, and mortality worldwide. We aimed to estimate global, regional, and national COPD prevalence
...
and risk factors to guide policy and population interventions.
more
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and
...
airflow limitation.
more
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and
...
airflow limitation.
more
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and
...
airflow limitation.
more
The Africa Health Organisation's fact sheet on Chronic Obstructive Pulmonary Disease (COPD).
The article provides a comprehensive overview of chronic obstructive pulmonary disease (COPD), covering its causes, symptoms, diagnostic methods, classification of severity, treatment options, and m
...
anagement strategies, with a focus on risk factors, clinical features, and therapeutic approaches such as smoking cessation, bronchodilators, rehabilitation, and potential surgical interventions.
more
