By Debbie Bunch
July 16, 2024
Primary Care Clinic Improves Care for COPD Patients
Chinese researchers publishing in JAMA Health Forum have found that a primary care clinic led by nurses and allied health professionals, including physiotherapists and occupational therapists, can significantly improve care for people with COPD.
The investigators compared outcomes among 3093 COPD who patients attended the Nurse and Allied Health Clinic-Respiratory Care (NAHC-Respiratory) and 5955 who did not. Specific findings included —
- Compared with patients in the usual care-only group, those who attended the clinic had a 16% lower risk of all-cause mortality, along with a lower risk for mortality caused by pneumonia, any respiratory condition, and any cardiovascular condition.
- Clinic attendance was associated with an 8% reduction in emergency department visits and reduced hospitalization through the emergency department as well.
The NAHC-Respiratory program consisted of patient education on physical exercise and lifestyle, smoking cessation, vaccinations, and pulmonary rehabilitation for patients with poor lung function. Outcomes were gauged after six years of follow-up.
“To our knowledge, this population-based cohort study is the first to examine the medium- or long-term health outcomes among patients who joined a protocol-driven, nurse- and allied health-led, multidisciplinary COPD management program,” write the authors. “This study provides evidence that the care model involving nurses and allied health professionals can facilitate COPD treatment, highlighting that health care professionals other than physicians are important in patient follow-up and disease management in the primary care setting.” Read Full Paper
Nasal Sprays May Reduce Symptoms Associated with Respiratory Infections
Patients with chronic lung conditions like asthma and COPD need to avoid respiratory infections whenever possible and minimize symptoms when they do come down with them. British researchers publishing in The Lancet Respiratory Medicine believe a nasal spray can help.
Their study was spurred by recent evidence suggesting nasal sprays can wash out virus from the nose and throat, along with other studies showing immune function may be increased via exercise and stress management. They decided to compare outcomes for 13,799 adult patients who were randomized to either one of two nasal spray groups, a group that was offered advice on exercise and stress management via an online resource, or usual care to find out how well these interventions work.
Everyone in the study had an existing health problem, a risk factor for infections, or a history of recurrent respiratory infections.
Patients randomized to the nasal spray groups used either Vicks-First-Defense gel-based nasal spray, which employs a microgel to trap viruses and neutralizes viruses in the nose, or a saline liquid-based nasal spray that reduces levels of virus in the nasopharynx.
While antibiotic use was reduced by about 25% in all three intervention groups when compared to usual care, patients in both of the nasal spray groups saw a reduction in overall illness duration of about 20% vs. just 5% for the online exercise/stress management group. A 20-30% reduction in days of lost work or normal activity was also seen in the nasal spray groups.
“Our results show nasal sprays work well to reduce the duration and severity of respiratory infections, and the interference with normal activities,” said study author Paul Little, from the University of Southampton. “Given these results, our advice, particularly for those at higher risk from infections or those who get recurrent infections, is at the first sign of cough, sore throat, cold, or flu-like symptoms, use a nasal spray to prevent it from developing fully, and to use the sprays preventatively after close exposure to people with infections.” Read Press Release Read Full Paper
Childhood Exposure to Air Pollution Linked to Bronchitic Symptoms in Adulthood
New research out of California suggests exposure to air pollution during childhood increases the risk for bronchitic symptoms later in life.
The investigators looked at data from the Southern California Children’s Health Study to assess the relationship. Overall, 1,308 participants were included in the report. Results linked higher concentrations of nitrogen dioxide (NO2) and particulate matter (PM10) during childhood with a higher likelihood of bronchitic symptoms such as bronchitis, chronic cough, or phlegm, during adulthood.
“For both NO2 and PM10, associations were stronger among participants who reported having childhood asthma,” explained lead author Erika Garcia, PhD, MPH, an assistant professor in the Division of Environmental Health at the Keck School of Medicine of USC. “Participants with childhood asthma may represent a subpopulation with increased susceptibility to the effects of air pollution exposure in childhood.”
The authors note the harmful effects of air pollution on children are due to their still developing lungs and immune systems, along with the fact that they breathe more air per kilogram of body weight than adults.
Dr. Garcia believes more regulatory efforts to reduce air pollution concentrations are needed to protect the public’s respiratory health.
The study was published by the American Journal of Respiratory and Critical Care Medicine. Read Press Release Read Abstract
