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  1. Article ; Online: Bronchodilator Responsiveness in Asthma and Chronic Obstructive Pulmonary Disease: Time to Stop Chasing Shadows.

    Halpin, David M G

    American journal of respiratory and critical care medicine

    2024  Volume 209, Issue 4, Page(s) 349–351

    MeSH term(s) Humans ; Bronchodilator Agents/therapeutic use ; Prevalence ; Asthma/physiopathology ; Pulmonary Disease, Chronic Obstructive/physiopathology
    Chemical Substances Bronchodilator Agents
    Language English
    Publishing date 2024-01-08
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202312-2248ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Clinical Management of COPD in the Real World: Can Studies Reveal Errors in Management and Pathways to Improve Patient Care?

    Halpin, David M G

    Pragmatic and observational research

    2023  Volume 14, Page(s) 51–61

    Abstract: Real world data comprise information on health care that is derived from multiple sources outside typical clinical research settings. This review focuses on what real world evidence tells us about problems with the diagnosis of chronic obstructive ... ...

    Abstract Real world data comprise information on health care that is derived from multiple sources outside typical clinical research settings. This review focuses on what real world evidence tells us about problems with the diagnosis of chronic obstructive pulmonary disease (COPD), problems with the initial and follow-up pharmacological and non-pharmacological management, problems with the management of exacerbations and problems with palliative care. Data from real world studies show errors in the management of COPD with delays to diagnosis, lack of confirmation of the diagnosis with spirometry, lack of holistic assessment, lack of attention to smoking cessation, variable adherence to management guidelines, delayed implementation of appropriate interventions, under-recognition of patients at higher risk of adverse outcomes, high hospitalisation rates for exacerbations and poor implementation of palliative care. Understanding that these problems exist and considering how and why they occur is fundamental to developing solutions to improve the diagnosis and management of patients with COPD.
    Language English
    Publishing date 2023-08-01
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2586661-8
    ISSN 1179-7266
    ISSN 1179-7266
    DOI 10.2147/POR.S396830
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Precision medicine in chronic obstructive pulmonary disease.

    Halpin, David M G

    Chinese medical journal

    2022  Volume 135, Issue 10, Page(s) 1156–1162

    Abstract: Abstract: Over the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target ... ...

    Abstract Abstract: Over the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.
    MeSH term(s) Biomarkers ; Humans ; Precision Medicine/methods ; Pulmonary Disease, Chronic Obstructive
    Chemical Substances Biomarkers
    Language English
    Publishing date 2022-05-20
    Publishing country China
    Document type Journal Article
    ZDB-ID 127089-8
    ISSN 2542-5641 ; 0366-6999 ; 1002-0187
    ISSN (online) 2542-5641
    ISSN 0366-6999 ; 1002-0187
    DOI 10.1097/CM9.0000000000002042
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Systematic review of the effects of patient errors using inhaled delivery systems on clinical outcomes in COPD.

    Halpin, David M G / Mahler, Donald A

    BMJ open respiratory research

    2024  Volume 11, Issue 1

    Abstract: Background: Errors using inhaled delivery systems for COPD are common and it is assumed that these lead to worse clinical outcomes. Previous systematic reviews have included patients with both asthma and COPD and much of the evidence related to asthma. ... ...

    Abstract Background: Errors using inhaled delivery systems for COPD are common and it is assumed that these lead to worse clinical outcomes. Previous systematic reviews have included patients with both asthma and COPD and much of the evidence related to asthma. More studies in COPD have now been published. Through systematic review, the relationship between errors using inhalers and clinical outcomes in COPD, including the importance of specific errors, was assessed.MethodsElectronic databases were searched on 27 October 2023 to identify cohort, case-control or randomised controlled studies, which included patients with COPD, an objective assessment of inhaler errors and data on at least one outcome of interest (forced expiratory volume in 1 s, (FEV
    Results: 19 publications were included (7 cohort and 12 case-control) reporting outcomes on 6487 patients. 15 were considered low quality, and most were confounded by the absence of adherence data. There was weak evidence that lower error rates are associated with better FEV
    Conclusion: Evidence about the importance of specific errors using inhalers and outcomes would optimise the education and training of patients with COPD. Prospective studies, including objective monitoring of inhalation technique and adherence, are needed.
    Prospero registration number: CRD42023393120.
    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Prospective Studies ; Asthma ; Nebulizers and Vaporizers ; Dyspnea
    Language English
    Publishing date 2024-04-16
    Publishing country England
    Document type Systematic Review ; Journal Article
    ZDB-ID 2736454-9
    ISSN 2052-4439 ; 2052-4439
    ISSN (online) 2052-4439
    ISSN 2052-4439
    DOI 10.1136/bmjresp-2023-002211
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: What Is Asthma Chronic Obstructive Pulmonary Disease Overlap?

    Halpin, David M G

    Clinics in chest medicine

    2020  Volume 41, Issue 3, Page(s) 395–403

    Abstract: The term asthma chronic obstructive pulmonary disease (COPD) overlap (ACO) has been popularized to describe people who simultaneously have features of both diseases. Analysis of the basis of disease classification and comparison of the clinical, ... ...

    Abstract The term asthma chronic obstructive pulmonary disease (COPD) overlap (ACO) has been popularized to describe people who simultaneously have features of both diseases. Analysis of the basis of disease classification and comparison of the clinical, pathophysiological, and therapeutic features of asthma and COPD concludes that it is not useful to use the term ACO. Rather, it is important to make the individual diagnoses, recognizing that both diseases may coexist. If a concurrent diagnosis of COPD is suspected in people with asthma, pharmacotherapy should primarily follow asthma guidelines, but pharmacologic and nonpharmacologic approaches also may be needed for COPD.
    MeSH term(s) Asthma/diagnosis ; Asthma/pathology ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/pathology
    Language English
    Publishing date 2020-08-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 447455-7
    ISSN 1557-8216 ; 0272-5231
    ISSN (online) 1557-8216
    ISSN 0272-5231
    DOI 10.1016/j.ccm.2020.06.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Consideration and Assessment of Patient Factors When Selecting an Inhaled Delivery System in COPD.

    Mahler, Donald A / Halpin, David M G

    Chest

    2023  Volume 165, Issue 2, Page(s) 323–332

    Abstract: Because guidelines and strategies for pharmacologic treatment of COPD focus on specific classes of inhaled medications, there is an unmet need for information to guide health care professionals for selecting an inhaled medication delivery system that ... ...

    Abstract Because guidelines and strategies for pharmacologic treatment of COPD focus on specific classes of inhaled medications, there is an unmet need for information to guide health care professionals for selecting an inhaled medication delivery system that matches the unique characteristics of individual patients. This article provides guidance for selecting an inhaled medication delivery system based on three "key" patient factors: cognitive function, manual dexterity/strength, and peak inspiratory flow. In addition, information is provided about specific tests to assess these patient factors. Cognitive impairment with an estimated prevalence of 25% among patients with COPD adversely affects patients' ability to correctly use a handheld device. To our knowledge, the prevalence of impaired manual dexterity/strength has not been reported in those with COPD. However, 79% of patients with COPD have reported one or more physical impediments that could influence their ability to manipulate an inhaler device. The measurement of peak inspiratory flow against the simulated resistance (PIFr) of a dry powder inhaler establishes whether the patient has the inhalation ability for creating optimal turbulent energy within the device. A suboptimal PIFr for low to medium-high resistance dry powder inhalers has been reported in 19% to 84% of stable outpatients with COPD. Health care professionals should consider cognitive function, manual dexterity/strength, and PIFr in their patients with COPD when prescribing inhaled pharmacotherapy. Impairments in these patient factors are common among those with COPD and can affect the individual's competency and effectiveness of using inhaled medications delivered by handheld devices.
    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive ; Administration, Inhalation ; Dry Powder Inhalers ; Prevalence ; Bronchodilator Agents
    Chemical Substances Bronchodilator Agents
    Language English
    Publishing date 2023-11-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2023.11.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Personalizing Selection of Inhaled Delivery Systems in Chronic Obstructive Pulmonary Disease.

    Mahler, Donald A / Halpin, David M G

    Annals of the American Thoracic Society

    2023  Volume 20, Issue 10, Page(s) 1389–1396

    Abstract: It can be challenging for healthcare professionals (HCPs) to prescribe inhaled therapy for patients with chronic obstructive pulmonary disease (COPD) because of the multiple individual and combinations of inhaled medications available in numerous ... ...

    Abstract It can be challenging for healthcare professionals (HCPs) to prescribe inhaled therapy for patients with chronic obstructive pulmonary disease (COPD) because of the multiple individual and combinations of inhaled medications available in numerous delivery systems. Guidance on the selection of an inhaled delivery system has received limited attention compared with the emphasis on prescribing the class of the inhaled molecule(s). Although numerous recommendations and algorithms have been proposed to guide the selection of an inhaled delivery system for patients with COPD, no specific approach has been endorsed in COPD guidelines/strategies or by professional organizations. To provide recommendations for an inhaler selection strategy at initial and follow-up appointments, we examined the impact of patient errors using handheld inhalers on clinical outcomes and performed a focused narrative review to consider patient factors (continuity of the inhaled delivery system, cognitive function, manual function/dexterity, and peak inspiratory flow) when selecting an inhaled delivery system. On the basis of these findings, five questions are proposed for HCPs to consider in the initial selection of an inhaler delivery system and three questions to consider at follow-up. We propose that HCPs consider the inhaled medication delivery system as a unit and to match appropriate medication(s) with the unique features of the delivery system to individual patient factors. Assessment of inhaler technique and adherence together with patient outcomes/satisfaction at each visit is essential to determine whether the inhaled medication delivery system is providing benefits. Continued and repeated education on device features and correct technique is warranted to optimize efficacy.
    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive ; Nebulizers and Vaporizers ; Pharmaceutical Preparations ; Patient Satisfaction ; Administration, Inhalation ; Bronchodilator Agents/therapeutic use
    Chemical Substances Pharmaceutical Preparations ; Bronchodilator Agents
    Language English
    Publishing date 2023-10-05
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.202304-384CME
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  8. Article ; Online: Tackling the global burden of lung disease through prevention and early diagnosis.

    Agusti, Alvar / Vogelmeier, Claus F / Halpin, David M G

    The Lancet. Respiratory medicine

    2022  Volume 10, Issue 11, Page(s) 1013–1015

    MeSH term(s) Humans ; Global Health ; Risk Factors ; Early Diagnosis ; Lung Diseases/diagnosis ; Lung Diseases/epidemiology ; Lung Diseases/prevention & control
    Language English
    Publishing date 2022-09-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(22)00302-2
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  9. Article ; Online: Lung Health for All: Chronic Obstructive Lung Disease and World Lung Day 2022.

    Halpin, David M G / Vogelmeier, Claus F / Agusti, Alvar

    American journal of respiratory and critical care medicine

    2022  Volume 206, Issue 6, Page(s) 669–671

    MeSH term(s) Humans ; Lung ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Thorax
    Language English
    Publishing date 2022-09-16
    Publishing country United States
    Document type Editorial
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202207-1407ED
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  10. Article ; Online: Pharmacotherapy and Mortality in Chronic Obstructive Pulmonary Disease.

    Halpin, David M G / Martinez, Fernando J

    American journal of respiratory and critical care medicine

    2022  Volume 206, Issue 10, Page(s) 1201–1207

    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Severity of Illness Index
    Language English
    Publishing date 2022-07-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202205-1000PP
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