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      International Journal of COPD (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on pathophysiological processes underlying Chronic Obstructive Pulmonary Disease (COPD) interventions, patient focused education, and self-management protocols. Sign up for email alerts here.

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      POPE study: rationale and methodology of a study to phenotype patients with COPD in Central and Eastern Europe

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          Abstract

          Introduction

          Chronic obstructive pulmonary disease (COPD) constitutes a major health challenge in Central and Eastern European (CEE) countries. However, clinical phenotypes, symptom load, and treatment habits of patients with COPD in CEE countries remain largely unknown. This paper provides a rationale for phenotyping COPD and describes the methodology of a large study in CEE.

          Methods/design

          The POPE study is an international, multicenter, observational cross-sectional survey of patients with COPD in CEE. Participation in the study is offered to all consecutive outpatients with stable COPD in 84 centers across the CEE region if they fulfill the following criteria: age >40 years, smoking history ≥10 pack-years, a confirmed diagnosis of COPD with postbronchodilator FEV 1/FVC <0.7, and absence of COPD exacerbation ≥4 weeks. Medical history, risk factors for COPD, comorbidities, lung function parameters, symptoms, and pharmaceutical and nonpharmaceutical treatment are recorded. The POPE project is registered in ClinicalTrials.gov with the identifier NCT02119494.

          Outcomes

          The primary aim of the POPE study was to phenotype patients with COPD in a real-life setting within CEE countries using predefined classifications. Secondary aims of the study included analysis of differences in symptoms, and diagnostic and therapeutic behavior in participating CEE countries.

          Conclusion

          There is increasing acceptance toward a phenotype-driven therapeutic approach in COPD. The POPE study may contribute to reveal important information regarding phenotypes and therapy in real-life CEE.

          Most cited references47

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

          W MacNee, , B Celli (2004)
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            Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.

            This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable chronic obstructive pulmonary disease (COPD) and is intended for clinicians who manage patients with COPD. This guideline addresses the value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies (anticholinergics, long-acting β-agonists, and corticosteroids), pulmonary rehabilitation programs, and supplemental oxygen therapy. This guideline is based on a targeted literature update from March 2007 to December 2009 to evaluate the evidence and update the 2007 ACP clinical practice guideline on diagnosis and management of stable COPD. RECOMMENDATION 1: ACP, ACCP, ATS, and ERS recommend that spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). RECOMMENDATION 2: For stable COPD patients with respiratory symptoms and FEV(1) between 60% and 80% predicted, ACP, ACCP, ATS, and ERS suggest that treatment with inhaled bronchodilators may be used (Grade: weak recommendation, low-quality evidence). RECOMMENDATION 3: For stable COPD patients with respiratory symptoms and FEV(1) 50% predicted. (Grade: weak recommendation, moderate-quality evidence). RECOMMENDATION 7: ACP, ACCP, ATS, and ERS recommend that clinicians should prescribe continuous oxygen therapy in patients with COPD who have severe resting hypoxemia (Pao(2) ≤55 mm Hg or Spo(2) ≤88%) (Grade: strong recommendation, moderate-quality evidence).
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              Biomass fuels and respiratory diseases: a review of the evidence.

              Globally, about 50% of all households and 90% of rural households use solid fuels (coal and biomass) as the main domestic source of energy, thus exposing approximately 50% of the world population-close to 3 billion people-to the harmful effects of these combustion products. There is strong evidence that acute respiratory infections in children and chronic obstructive pulmonary disease in women are associated with indoor biomass smoke. Lung cancer in women has been clearly associated with household coal use. Other conditions such as chronic obstructive pulmonary disease in men and tuberculosis could be also associated but evidence is scarce. According to estimates of the World Health Organization, more than 1.6 million deaths and over 38.5 million disability-adjusted life-years can be attributable to indoor smoke from solid fuels affecting mainly children and women. Interventions to suppress or reduce indoor exposure include behavior changes, improvements of household ventilation, improvements of stoves, and, outstandingly, transitions to better and cleaner fuels. These changes face personal and local beliefs and economic and sociocultural conditions. In addition, selection of fuels should consider cost, sustainability, and protection of the environment. Consequently, complex solutions need to be locally adapted, and involve the commitment and active participation of governments, scientific societies, nongovernmental organizations, and the general community.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2016
                22 March 2016
                : 11
                : 611-622
                Affiliations
                [1 ]Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
                [2 ]Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
                [3 ]Department of Respiratory Medicine, Faculty of Medicine, P.J. Safarik University, Kosice, Slovakia
                [4 ]Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto-Wagner-Spital, Wien, Austria
                [5 ]School of Medicine Zagreb, University Hospital Dubrava, Zagreb, Croatia
                [6 ]Laboratory of Pulmonology, Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia
                [7 ]Department of Pulmonology, University of Szeged, Deszk, Hungary
                [8 ]Pneumology Department, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
                [9 ]Department of Pneumology, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
                Author notes
                Correspondence: Vladimir Koblizek, Department of Pneumology, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University in Prague, Sokolska 581, 500 05 Hradec Kralove, Czech Republic, Tel +420 723 448 641, Email vladimir.koblizek@ 123456fnhk.cz
                Article
                copd-11-611
                10.2147/COPD.S88846
                4809323
                27042048
                116e48d5-fc9a-4832-aeb3-73841b565a8b
                © 2016 Zbozinkova et al. 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.

                History
                Categories
                Study Protocol

                Respiratory medicine
                copd,phenotypes,central europe,eastern europe,study,gold,comorbidity
                Respiratory medicine
                copd, phenotypes, central europe, eastern europe, study, gold, comorbidity

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