16
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The importance of patient perspectives in pulmonary hypertension

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The assessment of objective measurement of cardiopulmonary status has helped us achieve better clinical outcomes for patients and develop new therapies through to the point of market access; however, patient surveys indicate that more can be done to improve holistic care and patient engagement. In this multidisciplinary review, we examine how clinical teams can acknowledge and embrace the individual patient's perspective, and thus improve the care for individual patients suffering from pulmonary hypertension by cultivating the importance and relevance of health-related quality of life in direct clinical care. At the individual level, patients should be provided with access to accredited specialist centres which provide a multidisciplinary approach where there is a culture focused on narrative medicine, quality of life, shared decision making and timely access to palliative care, and where there is participation in education. On a larger scale, we call for the development, expansion and promotion of patient associations to support patients and carers, lobby for access to best care and treatments, and provide input into the development of clinical trials and registries, focusing on the patients’ perspective.

          Abstract

          Analysis and discussion on the importance of patients' perspectives in pulmonary hypertension http://ow.ly/edOt30mgYoI

          Related collections

          Most cited references59

          • Record: found
          • Abstract: found
          • Article: not found

          A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension.

          Primary pulmonary hypertension is a progressive disease for which no treatment has been shown in a prospective, randomized trial to improve survival. We conducted a 12-week prospective, randomized, multicenter open trial comparing the effects of the continuous intravenous infusion of epoprostenol (formerly called prostacyclin) plus conventional therapy with those of conventional therapy alone in 81 patients with severe primary pulmonary hypertension (New York Heart Association functional class III or IV). Exercise capacity was improved in the 41 patients treated with epoprostenol (median distance walked in six minutes, 362 m at 12 weeks vs. 315 m at base line), but it decreased in the 40 patients treated with conventional therapy alone (204 m at 12 weeks vs. 270 m at base line; P < 0.002 for the comparison of the treatment groups). Indexes of the quality of life were improved only in the epoprostenol group (P < 0.01). Hemodynamics improved at 12 weeks in the epoprostenol-treated patients. The changes in mean pulmonary-artery pressure for the epoprostenol and control groups were -8 percent and +3 percent, respectively (difference in mean change, -6.7 mm Hg; 95 percent confidence interval, -10.7 to -2.6 mm Hg; P < 0.002), and the mean changes in pulmonary vascular resistance for the epoprostenol and control groups were -21 percent and +9 percent, respectively (difference in mean change, -4.9 mm Hg/liter/min; 95 percent confidence interval, -7.6 to -2.3 mm Hg/liter/min; P < 0.001). Eight patients died during the study, all of whom had been randomly assigned to conventional therapy (P = 0.003). Serious complications included four episodes of catheter-related sepsis and one thrombotic event. As compared with conventional therapy, the continuous intravenous infusion of epoprostenol produced symptomatic and hemodynamic improvement, as well as improved survival in patients with severe primary pulmonary hypertension.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension.

            Data on the effect of initial combination therapy with ambrisentan and tadalafil on long-term outcomes in patients with pulmonary arterial hypertension are scarce.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Selexipag for the Treatment of Pulmonary Arterial Hypertension.

              In a phase 2 trial, selexipag, an oral selective IP prostacyclin-receptor agonist, was shown to be beneficial in the treatment of pulmonary arterial hypertension.
                Bookmark

                Author and article information

                Journal
                Eur Respir J
                Eur. Respir. J
                ERJ
                erj
                The European Respiratory Journal
                European Respiratory Society
                0903-1936
                1399-3003
                January 2019
                24 January 2019
                : 53
                : 1
                : 1801919
                Affiliations
                [1 ]Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA
                [2 ]Pulmonary Hypertension Association Europe, Vienna, Austria
                [3 ]Pulmonary Hypertension Association UK, Sheffield, UK
                [4 ]Sociedad Latina de Hipertensión Pulmonar, Venezuela
                [5 ]National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
                [6 ]Jenna Lowe Trust, Republic of South Africa
                [7 ]London Health Sciences Centre, Division of Respirology, Dept of Medicine, Schulich School of Medicine, Western University and Pulmonary Hypertension Association Canada, London, ON, Canada
                [8 ]Pulmonary Hypertension Association Japan, Tokyo, Japan
                [9 ]Pulmonary Hypertension Association, Silver Spring, MD, USA
                Author notes
                Michael D. McGoon, Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. E-mail: mdmcgoon@ 123456gmail.com
                Article
                ERJ-01919-2018
                10.1183/13993003.01919-2018
                6351339
                30545977
                e714ccac-7350-4abc-a367-46abb118cdcd
                Copyright ©ERS 2019

                This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                : 07 October 2018
                : 09 October 2018
                Categories
                Series
                World Symposium on Pulmonary Hypertension

                Respiratory medicine
                Respiratory medicine

                Comments

                Comment on this article