BMJ Open Respiratory Research

BackgroundFatigue, breathlessness and cough are prevalent symptoms of Interstitial Lung Disease (ILD) adversely impacting quality-of-life and contributing to psychological distress. The Fatigue and Breathlessness (FAB) programme facilitates supported self-management for people living with life-limiting conditions such as cancer. We explore its utility when adapted for people living with ILD. MethodsThe 4-week ILD-FAB programme offers each group of up to 6 participants weekly two-hour sessions l...

BackgroundA COVID-19 hospital guideline was implemented across all acute hospitals in Wales in March 2020, and data was collected across the first 3 Waves of the pandemic. We aimed to observe trends in mortality with a focus on ward-based outcomes. MethodsRetrospective case-note review of data for adults admitted to hospital with community acquired COVID-19 between March 2020 and December 2021 Results5887 cases were analysed. Overall mortality from COVID-19 fell from 31.5% in Wave 1 to 22.6% i...

ObjectiveTo characterize Pulmonary rehabilitation (PR) service delivery, investigate the impact of the pandemic on PR services, and describe centre-based PR (CBPR) and telerehabilitation with reference to PR essential components. DesignOnline national cross-sectional survey. SettingAustralian PR services. ParticipantsRepresentatives of PR programs listed within the Lung Foundation Australia national database (n=295). InterventionsNot applicable. Main Outcome Measure(s)Availability of PR in ...

BackgroundLow muscle oxidative capacity is an extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD) with unclear etiology. We sought to determine clinical and behavioral features associated with muscle oxidative capacity in smokers with and without COPD and never smoker individuals. Methods243 adults enrolled in the Muscle Health Study, an observational study ancillary to COPDGene. Gastrocnemius oxidative capacity was measured by near-infrared spectroscopy from muscle oxy...

BackgroundAsthma is misdiagnosed in one-third of patients. Due to its variable nature, international guidelines recommend performing key diagnostic tests during symptomatic periods or in the morning to improve accuracy. Limited access to timely clinic appointments and community-based diagnostics makes this difficult. Handheld spirometry and fractional exhaled nitric oxide (FeNO) are feasible for home use, enabling timely and flexible testing. ObjectiveTo explored patients views on performing sp...

BACKGROUNDThis study investigated clinical usage of non-invasive ventilation during physical therapy for people with cystic fibrosis. Specific research questions were: What are the clinical indications, contraindications and patient selection criteria for non-invasive ventilation use as an adjunct to physical therapy in people with cystic fibrosis? 2. Who implements non-invasive ventilation, what settings are used and how are they determined? 3. What outcome measures are used to determine the ef...

BackgroundCOVID-19 causes a wide spectrum of disease. The incidence and severity of sequelae after the acute infection is uncertain. Data measuring the longer-term impact of COVID-19 on symptoms, radiology and pulmonary function are urgently needed to plan follow-up services. MethodsConsecutive patients hospitalised with COVID-19 were prospectively recruited to this observational study with outcomes recorded at 28-days. All were invited to a systematic follow up at 8-12 weeks, including chest r...

Question(s)What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in terms of service provision, scope of practice and skill mix changes in an acute respiratory service? DesignA pragmatic pre-post design study examined physiotherapy services across two three-month periods: current service delivery [P1] and current service delivery plus AHA [P2]. Outcome measuresClinical and non-clinical activity contributing to physiotherapy services delivery qu...

ObjectivesEvaluate clinical outcomes associated with implementing a specialist pneumonia intervention nursing (SPIN) service, to improve adherence with BTS guidelines for hospitalised community acquired pneumonia (CAP). DesignRetrospective cohort study, comparing periods before (2011-13) and after (2014-16) SPIN service implementation. SettingSingle NHS trust across two hospital sites in Leicester City, England Participants13,496 adult (aged [≥]16) admissions to hospital with a primary dia...

BackgroundLung function assessment is essential for respiratory medicine and health. Recommended international reference values differ by race, which is controversial. We evaluated the effect of adjusting lung function for race on prevalence of lung function impairment, breathlessness and mortality in the US population. MethodsPopulation-based analysis of the National Health and Nutrition Examination Survey (NHANES) 2007-2012. Race was analyzed as black, white, or other. Lung function was asses...

BackgroundChronic Obstructive Pulmonary Disease (COPD) imposes a significant burden on individuals and communities. While differences in such burden are often studied across countries and healthcare systems, differences within jurisdictions have not been well evaluated. The aim of this study was to assess the trends of, and factors explaining, regional variability in the burden of COPD within a well-defined population with publicly funded healthcare system. MethodologyWe used population-based h...

BackgroundInterstitial lung diseases (ILD) are a heterogenous group of often progressive, unpredictable diseases. They frequently result in hospitalisations secondary to respiratory decompensation, termed ILD-related admissions. A proportion of these are due to acute exacerbations (AEILD). All are associated with high mortality but poorly characterised in real-world populations. AimTo evaluate mortality outcomes and associated risk factors following ILD-related hospital admissions, including AE...

BackgroundSex is an important part of life for many adults, yet sexual function may be impacted by chronic respiratory diseases such as pulmonary fibrosis (PF). This multinational study sought to characterize the impact of PF on sex and sexual function, using mixed quantitative and qualitative methodology. MethodsPatients were retrospectively included from a prospective registry and prospective clinical cohort if they had completed UCSD-SOBQ or SPARC questionnaire, respectively. An online multi...

BackgroundExertional breathlessness is the cardinal symptom in cardiorespiratory disease. We aimed to validate recently developed normative reference equations to evaluate breathlessness abnormality during cardiopulmonary exercise testing (CPET) in people with chronic airflow limitation. MethodsAnalysis of people aged [≥]40 years with chronic airflow limitation undergoing CPET in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Breathlessness intensity ratings (Borg 0-10 categor...

BackgroundExertional breathlessness is a key symptom in cardiorespiratory disease and can be quantified using incremental exercise testing (IET), but its prognostic significance is unknown. Research questionWe evaluated the ability of abnormally high breathlessness intensity during IET to predict all-cause, respiratory, and cardiac mortality. Study Design and MethodsLongitudinal cohort study of adults referred for cycle IET followed prospectively for mortality assessed using the Swedish Nation...

IntroductionThe impact of the SARS-CoV-2 pandemic, and lockdown measures, on acute exacerbations of COPD (AECOPD) is unknown. We aimed to evaluate the change in AECOPD treatment frequency during the first six weeks of lockdown in the UK compared with 2019 and assess changes in self-reported behaviour and well-being. MethodsIn this observational study patients with established COPD were recruited. Exacerbation frequency was measured in the first six weeks of COVID lockdown and compared with the ...

BackgroundThe prevalence of COPD is increasing with age. However, the effects of age-dependent decline in lung function on diagnosis and treatment of COPD in nonagenarians are uncertain. ObjectivesTo determine performance of spirometry, prescription of COPD medications, and COPD-related acute care visits and hospitalizations in patients 90 years and older with physician-diagnosed COPD. MethodsHealth records of 166 consecutive patients 90 years and older with physician-diagnosed COPD at a unive...

BackgroundIdiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis and declining quality of life. Patient-reported outcomes (PROs) provide a comprehensive understanding of a patients experience and health status than clinical measures (COs) alone, capturing how patients feel, function, and experience their health. However, the relationship between PROs and COs remains incompletely understood in this population. MethodsWe performed a secondary analysis of data from the YES-IP...

RationaleSupplemental oxygen is often prescribed to patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). The specific costs of oxygen therapy in these diseases have not been fully described in patients living in the United States. ObjectivesEstimate Medicaid/Medicare costs for supplemental oxygen, characterize differences in oxygen equipment utilization, and identify factors impacting the costs of supplemental oxygen therapy in ILD and COPD. MethodsWe...

BackgroundRecent reports highlight the importance of acute lower respiratory tract disease (aLRTD) for patients, but data describing incidence and burden in emergency departments (ED) are lacking. MethodsA cohort study ascertaining cases prospectively at two EDs in Bristol, UK, enrolling adults ([≥]18years [y]) presenting with aLRTD from 01-Aug-22 to 31-Jul-23. Multivariate logistic regression modelled risk of hospitalisation. Incidence was estimated per 1000 person-years, using adult popula...