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Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD

PURPOSE: Heterogeneous nature of Chronic Obstructive Pulmonary Disease (COPD) must be comprehensively addressed. It is unclear if integrative multidisciplinary disease management (IMDM) can optimize clinical outcomes of patients with COPD. METHODS: A single-center, retrospective cohort observational...

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Autores principales: Mansoor, Sahar, Obaida, Zaid, Ballowe, Lorna, Campbell, Amanda R, Patrie, James T, Byrum, Timothy D, Shim, Yun M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955613/
https://www.ncbi.nlm.nih.gov/pubmed/32021142
http://dx.doi.org/10.2147/COPD.S225156
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author Mansoor, Sahar
Obaida, Zaid
Ballowe, Lorna
Campbell, Amanda R
Patrie, James T
Byrum, Timothy D
Shim, Yun M
author_facet Mansoor, Sahar
Obaida, Zaid
Ballowe, Lorna
Campbell, Amanda R
Patrie, James T
Byrum, Timothy D
Shim, Yun M
author_sort Mansoor, Sahar
collection PubMed
description PURPOSE: Heterogeneous nature of Chronic Obstructive Pulmonary Disease (COPD) must be comprehensively addressed. It is unclear if integrative multidisciplinary disease management (IMDM) can optimize clinical outcomes of patients with COPD. METHODS: A single-center, retrospective cohort observational study with a historical intervention was conducted in a clinic specialized for COPD care. Patients with a confirmed diagnosis of COPD were administered IMDM with measurement of BODE score on initial and follow-up visits. Primary outcomes were dynamic changes in BODE quartiles after receiving IMDM. RESULTS: Of 124 patients, 21% were misdiagnosed with COPD. Patients with a confirmed diagnosis of COPD were 50% female, median age 64 years (IQR 57–70), 43% actively smoking and initial visit median BODE quartile 2 (IQR 1–3). Three subgroups were identified based on the changes in BODE quartiles: worsened (21%), unchanged (55%) and improved (24%). At baseline, mMRC (median [IQR]) was higher in improved subgroup vs worsened and unchanged subgroup (3 [3, 4] vs 2 [1, 2] vs 2 [1, 3], p value 0.002) respectively. Drop in all components of BODE score was noted in worsened group, but significant improvement in mMRC with preservation of spirometry values was noted in the improved group. The incidence of smoking cigarettes changed from 39% to 26% during follow-up. CONCLUSION: Our study demonstrates that IMDM can be potentially effective in a subgroup of COPD patients. In others precipitous drop in lung function, activity tolerance, and subjective symptoms seems inevitable with worsening BODE quartiles.
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spelling pubmed-69556132020-02-04 Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD Mansoor, Sahar Obaida, Zaid Ballowe, Lorna Campbell, Amanda R Patrie, James T Byrum, Timothy D Shim, Yun M Int J Chron Obstruct Pulmon Dis Original Research PURPOSE: Heterogeneous nature of Chronic Obstructive Pulmonary Disease (COPD) must be comprehensively addressed. It is unclear if integrative multidisciplinary disease management (IMDM) can optimize clinical outcomes of patients with COPD. METHODS: A single-center, retrospective cohort observational study with a historical intervention was conducted in a clinic specialized for COPD care. Patients with a confirmed diagnosis of COPD were administered IMDM with measurement of BODE score on initial and follow-up visits. Primary outcomes were dynamic changes in BODE quartiles after receiving IMDM. RESULTS: Of 124 patients, 21% were misdiagnosed with COPD. Patients with a confirmed diagnosis of COPD were 50% female, median age 64 years (IQR 57–70), 43% actively smoking and initial visit median BODE quartile 2 (IQR 1–3). Three subgroups were identified based on the changes in BODE quartiles: worsened (21%), unchanged (55%) and improved (24%). At baseline, mMRC (median [IQR]) was higher in improved subgroup vs worsened and unchanged subgroup (3 [3, 4] vs 2 [1, 2] vs 2 [1, 3], p value 0.002) respectively. Drop in all components of BODE score was noted in worsened group, but significant improvement in mMRC with preservation of spirometry values was noted in the improved group. The incidence of smoking cigarettes changed from 39% to 26% during follow-up. CONCLUSION: Our study demonstrates that IMDM can be potentially effective in a subgroup of COPD patients. In others precipitous drop in lung function, activity tolerance, and subjective symptoms seems inevitable with worsening BODE quartiles. Dove 2020-01-08 /pmc/articles/PMC6955613/ /pubmed/32021142 http://dx.doi.org/10.2147/COPD.S225156 Text en © 2020 Mansoor et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Mansoor, Sahar
Obaida, Zaid
Ballowe, Lorna
Campbell, Amanda R
Patrie, James T
Byrum, Timothy D
Shim, Yun M
Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title_full Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title_fullStr Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title_full_unstemmed Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title_short Clinical Impact of Multidisciplinary Outpatient Care on Outcomes of Patients with COPD
title_sort clinical impact of multidisciplinary outpatient care on outcomes of patients with copd
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955613/
https://www.ncbi.nlm.nih.gov/pubmed/32021142
http://dx.doi.org/10.2147/COPD.S225156
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