|Type||Journal Article (Original Research)|
|Journal||Medical Journal of Australia|
|Year of Publication||2018|
|Download||105694mja17_00664_.pdf (301.8 KB)|
|Abstract||OBJECTIVES: To review the accuracy of diagnoses of chronic obstructive pulmonary disease (COPD) in primary care in Australia, and to describe smokers' experiences with and preferences for smoking cessation. DESIGN, SETTING AND PARTICIPANTS: Patients were invited to participate if they were at least 40 years old and had visited participating general practice clinics in Melbourne at least twice during the previous 12 months, reported being current or ex-smokers with a smoking history of at least 10 pack-years, or were being managed for COPD. Interviews based on a structured questionnaire and case finding (FEV1/FEV6 measurement) were followed, when appropriate, by spirometry testing and assessment of health-related quality of life, dyspnoea and symptoms. RESULTS: 1050 patients attended baseline interviews (February 2015 - April 2017) at 41 practices. Of 245 participants managed for COPD, 130 (53.1%) met the spirometry-based definition (post-bronchodilator FEV1/FVC < 0.7) or had a clinical correlation; in 37% of cases COPD was not confirmed, and no definitive result was obtained for 9.8% of patients. Case finding and subsequent spirometry testing identified 142 new COPD cases (17.6% of participants without prior diagnosis; 95% CI, 15.1-20.5%). 690 participants (65.7%) were current smokers, of whom 360 had attempted quitting during the previous 12 months; 286 (81.0% of those attempting to quit) reported difficulties during previous quit attempts. Nicotine replacement therapy (205, 57.4%) and varenicline (110, 30.8%) were the most frequently employed pharmacological treatments; side effects were common. Hypnotherapy was the most popular non-pharmacological option (62 smokers, 17%); e-cigarettes were tried by 38 (11%). 187 current smokers (27.6%) would consider using e-cigarettes in future attempts to quit. CONCLUSIONS: COPD was both misdiagnosed and missed. Case finding and effective use of spirometry testing could improve diagnosis. Side effects of smoking cessation medications and difficulties during attempts to quit smoking are common. Health professionals should emphasise evidence-based treatments, and closely monitor quitting difficulties and side effects of cessation aids. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614001155684.|
Interstitial lung disease (ILD) is a chronic lung condition that causes stiff lungs and restricts sufferers from taking a deep breath. Exercise in a gym, such as walking or riding a bike, can help make...
Sleep apnea is a condition where breathing is abnormal during sleep. There are two main forms of sleep apnea: obstructive and central. For obstructive sleep apnea, breathing is reduced because the airway...
Each year in Australia 260 people sustain a SCI, with over half losing full function in their arms and legs (quadriplegia). In addition to the primary disability, there is a very high rate of Obstructive...
Melbourne researchers have found that 80 percent of people with quadriplegic spinal injuries have sleep apnoea. It's having a big effect on their lives but they don't know they have it, and they don't know it can be treated.
The National Transport Commission (NTC) and the Cooperative Research Centre for Alertness, Safety and Productivity (Alertness CRC) have released the results of what is hailed as a world-first study into heavy vehicle driver fatigue.
AAMRI released its election statement calling on politicians to commit to three main priorities: ensuring the MRFF reaches $20 billion by 2020-21, provide continued strong support for the NHMRC, and develop sustainable and rewarding career pathways.
IBAS Director Anna Burke had barely got into the swing of her speech at the unveiling of her portrait at Canberra's Parliament House when the ringing of bells caused half her audience to hurry away.