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7. Depression symptoms reduce physical activity in COPD patients: a prospective multicenter study

Author

Dueñas-Espín I, Demeyer H, Gimeno-Santos E, Polkey MI, Hopkinson NS, Rabinovich RA, Dobbels F, Karlsson N, Troosters T, and Garcia-Aymerich J

Subjects
COPD, anxiety, depression, HADS, physical activity, prospective study., Diseases of the respiratory system, RC705-779
Abstract

Iván Dueñas-Espín,1–5 Heleen Demeyer,6 Elena Gimeno-Santos,1–3 Michael I Polkey,7 Nicholas S Hopkinson,7 Roberto A Rabinovich,8 Fabienne Dobbels,9 Niklas Karlsson,10 Thierry Troosters,6,11 Judith Garcia-Aymerich1–3 On behalf of the PROactive Consortium 1ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 2Universitat Pompeu Fabra (UPF), 3CIBEREpidemiología y Salud Pública (CIBERESP), Barcelona, Spain; 4Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación del Ecuador (SENESCYT), Quito, Ecuador; 5Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; 6Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; 7NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK; 8ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK; 9Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium; 10Health Economics and Outcomes Research, AstraZeneca R&D, Mölndal, Sweden; 11Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium Background: The role of anxiety and depression in the physical activity (PA) of patients with COPD is controversial. We prospectively assessed the effect of symptoms of anxiety and depression on PA in COPD patients.Methods: We evaluated anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), PA (Dynaport® accelerometer), and other relevant characteristics in 220 COPD patients from five European countries at baseline and at 6 and 12 months of follow-up. HADS score was categorized as: no symptoms (score 0–7), suggested (8–10), and probable (>11) anxiety or depression. We estimated the association between anxiety and depression at t (baseline and 6 months) and PA at t+1 (6 and 12 months) using regression models with a repeated measures approach.Results: Patients had a mean (standard deviation) age of 67 (8) years, forced expiratory volume in 1 second 57 (20)% predicted. At baseline, the prevalence of probable anxiety and depression was 10% and 5%, respectively. In multivariable models adjusted by confounders and previous PA, patients performed 81 fewer steps/day (95% confidence interval, -149 to -12, P=0.02) per extra point in HADS-depression score. HADS-anxiety symptoms were not associated with PA.Conclusion: In COPD patients, symptoms of depression are prospectively associated with a measurable reduction in PA 6 months later. Keywords: COPD, anxiety, depression, HADS, physical activity, prospective study

Published
2016

13. Patrones de progresión de la actividad física en pacientes con EPOC

Author

Koreny, M, Demeyer, H, Benet, M, Arbillaga-Etxarri, A, Balcells, E, Barberan-Garcia, A, Gimeno-Santos, E, Hopkinson, NS, De Jong, C, Karlsson, N, Louvaris, Z, Polkey, MI, Puhan, MA, Rabinovich, RA, Rodríguez-Roisin, R, Vall-Casas, P, Vogiatzis, I, Troosters, T, Garcia-Aymerich, J, Urban Training Study Group and PROactive Consortium members, Urban Training Study Group, Delgado, A, Torrent-Pallicer, J, Vilaró, J, Chiaradía, DAR, Marín, A, Ortega, P, Celorrio, N, Teagudo, MM, Montellà, N, Muñoz, L, Toran, P, Simonet, P, Jané, C, Martín-Cantera, C, Borrell, E, PROactive Consortium members, Ivanoff, N, Corriol-Rohou, S, Jarrod, I, Erzen, D, Brindicci, C, Higenbottam, T, Scuri, M, McBride, P, Kamel, N, Tabberer, M, Dobbels, F, De Boer, P, Kulich, K, Glendenning, A, Rudell, K, Wilson, FJ, Nikai, E, Van der Molen, T, MacNee, B, Frei, A, Groningen Research Institute for Asthma and COPD (GRIAC), and EU/IMI Joint Undertaking

Subjects
Male, PROactive Consortium members, Respiratory System, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Medicine and Health Sciences, Pooled data, Determinants, COPD, biology, Patrones de progresión, General Medicine, Lama, Análisis de conglomerados, Respiratory Function Tests, MPOC, Female, EPOC, Determinantes, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Patrons de progressió, Physical activity, 616.2, 03 medical and health sciences, FEV1/FVC ratio, Cluster analysis, Multinomial logistic regression model, Internal medicine, Urban Training Study Group, medicine, Humans, Anàlisi de clústers, In patient, Exercise, Patterns of progression, business.industry, 1103 Clinical Sciences, medicine.disease, biology.organism_classification, C600, Urban Training Study Group and PROactive Consortium members, B900, Dyspnea, 030228 respiratory system, Usual care, Actividad física, Sedentary Behavior, Activitat física, business
Abstract

Introduction: Although mean physical activity in COPD patients declines by 400–500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Δ): −487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Δ: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Δ: −2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90–0.98] per 10 m, P = .001) and a higher mMRC dyspnea score (1.71 [1.12–2.60] per 1 point, P = .012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline. Introducción: Aunque la actividad física en pacientes con EPOC declina una media anual de 400-500 pasos/día, se desconoce si esta progresión es igual en todos los pacientes. Este estudio pretendió identificar los patrones de progresión de la actividad física mediante métodos libres de hipótesis y evaluar sus determinantes. Métodos: Se estudiaron 291 pacientes con EPOC estable (media ± DE: 68 ± 8 años, 81% hombres, VEMS 59 ± 19%pred) de dos cohortes europeas con actividad física basal y a 12 meses (acelerómetro Dynaport MoveMonitor). Se identificaron conglomerados (patrones) de progresión de actividad física basados en los niveles y cambios de pasos/día usando k-means, y se compararon entre patrones las características sociodemográficas, interpersonales, ambientales, clínicas y psicosociales basales. Resultados: Se identificaron tres patrones: inactivo (n = 173 [59%], basal: 4.621 ± 1.757 pasos/día, cambio en 12 meses (Δ): −487 ± 1.201 pasos/día), activo que aumenta (n = 49 [17%], basal: 7.727 ± 3.275 pasos/día, Δ: +3.378 ± 2.203 pasos/día) y activo que reduce (n = 69 [24%], basal: 11.267 ± 3.009 pasos/día, Δ: −2.217 ± 2.085 pasos/día). La distancia en la prueba de la marcha de 6 minutos (6MWD) y la disnea se asociaron independientemente con ser inactivo: RRR [IC 95%] 0,94 [0,90-0,98] por cada 10 m de 6MWD (p = 0,001) y 1,71 [1,12-2,60] por cada punto en la escala mMRC (p = 0,012), respectivamente, en comparación con el patrón activo que reduce. No se encontraron variables basales independientemente asociadas con ser activo que aumenta. Conclusiones: La progresión natural de la actividad física en pacientes con EPOC es heterogénea. Mientras que el patrón de pacientes inactivo se relaciona con peores características clínicas de EPOC, no se pudo predecir la evolución de los activos a aumentar o reducir. info:eu-repo/semantics/acceptedVersion

Published
2021

14. Patterns of Physical Activity Progression in Patients With COPD [Patrones de progresión de la actividad física en pacientes con EPOC]

Author

Koreny, M. Demeyer, H. Benet, M. Arbillaga-Etxarri, A. Balcells, E. Barberan-Garcia, A. Gimeno-Santos, E. Hopkinson, N.S. De Jong, C. Karlsson, N. Louvaris, Z. Polkey, M.I. Puhan, M.A. Rabinovich, R.A. Rodríguez-Roisin, R. Vall-Casas, P. Vogiatzis, I. Troosters, T. Garcia-Aymerich, J. Delgado, A. Torrent-Pallicer, J. Vilaró, J. Rodriguez-Roisín, R. Chiaradía, D.A.R. Marín, A. Ortega, P. Celorrio, N. Monteagudo, M. Montellà, N. Muñoz, L. Toran, P. Simonet, P. Jané, C. Martín-Cantera, C. Borrell, E. Ivanoff, N. Corriol-Rohou, S. Jarrod, I. Erzen, D. Brindicci, C. Higenbottam, T. Scuri, M. McBride, P. Kamel, N. Tabberer, M. Dobbels, F. de Boer, P. Kulich, K. Glendenning, A. Rudell, K. Wilson, F.J. Hopkinson, N.S. Nikai, E. van der Molen, T. MacNee, B. Frei, A. The Urban Training Study Group PROactive Consortium members The Urban Training Study Group The PROactive Consortium members

Abstract

Introduction: Although mean physical activity in COPD patients declines by 400–500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Δ): −487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Δ: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Δ: −2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90–0.98] per 10 m, P =.001) and a higher mMRC dyspnea score (1.71 [1.12–2.60] per 1 point, P =.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline. © 2020 SEPAR

Published
2021

15. Validity and responsiveness of the Daily-and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments

Author

Garcia-Aymerich, J. Puhan, M.A. Corriol-Rohou, S. De Jong, C. Demeyer, H. Dobbels, F. Erzen, D. Frei, A. Gimeno-Santos, E. Hopkinson, N.S. Ivanoff, N. Karlsson, N. Louvaris, Z. Polkey, M.I. Rabinovich, R.A. Scuri, M. Tabberer, M. Vogiatzis, I. Troosters, T.

Abstract

Background The Daily-PROactive and Clinical visit-PROactive Physical Activity (D-PPAC and C-PPAC) instruments in chronic obstructive pulmonary disease (COPD) combines questionnaire with activity monitor data to measure patients' experience of physical activity. Their amount, difficulty and total scores range from 0 (worst) to 100 (best) but require further psychometric evaluation. Objective To test reliability, validity and responsiveness, and to define minimal important difference (MID), of the D-PPAC and C-PPAC instruments, in a large population of patients with stable COPD from diverse severities, settings and countries. Methods We used data from seven randomised controlled trials to evaluate D-PPAC and C-PPAC internal consistency and construct validity by sex, age groups, COPD severity, country and language as well as responsiveness to interventions, ability to detect change and MID. Results We included 1324 patients (mean (SD) age 66 (8) years, forced expiratory volume in 1 s 55 (17)% predicted). Scores covered almost the full range from 0 to 100, showed strong internal consistency after stratification and correlated as a priori hypothesised with dyspnoea, health-related quality of life and exercise capacity. Difficulty scores improved after pharmacological treatment and pulmonary rehabilitation, while amount scores improved after behavioural physical activity interventions. All scores were responsive to changes in self-reported physical activity experience (both worsening and improvement) and to the occurrence of COPD exacerbations during follow-up. The MID was estimated to 6 for amount and difficulty scores and 4 for total score. Conclusions The D-PPAC and C-PPAC instruments are reliable and valid across diverse COPD populations and responsive to pharmacological and non-pharmacological interventions and changes in clinically relevant variables. © Author(s) (or their employer(s)) 2021.

Published
2021

16. Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and meta-analysis

Author

Torres-Castro, R, Gimeno-Santos, E, Vilaro, J, Roque-Figuls, M, Moises, J, Vasconcello-Castillo, L, Orizaga, T, Barbera, JA, and Blanco, I

Abstract

Background Pulmonary hypertension (PH) is a frequent complication in patients with COPD. Objective To determine if, in patients with COPD, the presence of PH decreases exercise tolerance. Methods We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence. Results Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V'(O2peak)), -3.09 mL.kg(-1).min(-1) (95% CI -4.74 to -1.43, p=0.0003); maximum workload (W-max), -20.5 W (95% CI -34.4 to -6.5, p=0.004); and oxygen pulse (O-2 pulse), -1.24 mL.beat(-1) (95% CI -2.40 to -0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences: V'(O2), -4.26 mL.min(-1).kg(-1) (95% CI -5.50 to -3.02 mL.kg(-1).min(-1), p

Published
2021

21. Evaluation of a 12 weeks smartphone-based physical activity telecoaching intervention in chronic obstructive pulmonary disease: patient experience and lessons for implementation

Author

Troosters, Thierry, Loeckx, Matthias, Rabinovich, R, Demeyer, Heleen, Louvaris, Zafeiris, Tanner, R, Rubio, N, Frei, A, De Jong, C, Gimeno-Santos, E, Rodrigues, FM, Buttery, SC, Hopkinson, NS, Buesching, G, Strassman, A, Serra, I, Vogiatzis, I, Garcia-Aymerich, J, and Polkey, M

Abstract

ispartof: Journal of Medical Internet Research status: accepted

Published
2018

22. Multimodal prehabilitation: a promising strategy in patients listed for heart transplantation

Author

Arguis, M.J., primary, Navarro-Ripoll, R., additional, Lopez-Hernandez, A., additional, Gimeno-Santos, E., additional, López-Baamonde, M., additional, Romano, B., additional, Montane-Muntane, M., additional, Dana, F., additional, Perdomo, J.M., additional, Sandoval, E., additional, Merino, L., additional, Matute, P., additional, Moises, J., additional, Farrero, M., additional, Castel, M.A., additional, and Martínez-Pallí, G., additional

Published
2019
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23. Both moderate and severe exacerbations accelerate physical activity decline in COPD patients

Author

Demeyer, H. Costilla-Frias, M. Louvaris, Z. Gimeno-Santos, E. Tabberer, M. Rabinovich, R.A. De Jong, C. Polkey, M.I. Hopkinson, N.S. Karlsson, N. Serra, I. Vogiatzis, I. Troosters, T. Garcia-Aymerich, J. Ivanoff, N. Karlsson, N. Corriol-Rohou, S. Jarrod, I. Erzen, D. Scuri, M. Montacchini, R. McBride, P. Kamel, N. Tabberer, M. Troosters, T. Janssens, W. Demeyer, H. Dobbels, F. De Boer, P. Kulich, K. Polkey, M.I. Hopkinson, N.S. Vogiatzis, I. Nikai, E. Van Der Molen, T. De Jong, C. Rabinovich, R.A. MacNee, B. Puhan, M.A. Frei, A.

Published
2018

24. Smartphone-based physical activity telecoaching in chronic obstructive pulmonary disease: Mixed-methods study on patient experiences and lessons for implementation

Author

Loeckx, M. Rabinovich, R.A. Demeyer, H. Louvaris, Z. Tanner, R. Rubio, N. Frei, A. De Jong, C. Gimeno-Santos, E. Rodrigues, F.M. Buttery, S.C. Hopkinson, N.S. Büsching, G. Strassmann, A. Serra, I. Vogiatzis, I. Garcia-Aymerich, J. Polkey, M.I. Troosters, T.

Abstract

Background: Telecoaching approaches can enhance physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD). However, their effectiveness is likely to be influenced by intervention-specific characteristics. Objective: This study aimed to assess the acceptability, actual usage, and feasibility of a complex PA telecoaching intervention from both patient and coach perspectives and link these to the effectiveness of the intervention. Methods: We conducted a mixed-methods study based on the completers of the intervention group (N=159) included in an (effective) 12-week PA telecoaching intervention. This semiautomated telecoaching intervention consisted of a step counter and a smartphone app. Data from a project-tailored questionnaire (quantitative data) were combined with data from patient interviews and a coach focus group (qualitative data) to investigate patient and coach acceptability, actual usage, and feasibility of the intervention. The degree of actual usage of the smartphone and step counter was also derived from app data. Both actual usage and perception of feasibility were linked to objectively measured change in PA. Results: The intervention was well accepted and perceived as feasible by all coaches present in the focus group as well by patients, with 89.3% (142/159) of patients indicating that they enjoyed taking part. Only a minority of patients (8.2%; 13/159) reported that they found it difficult to use the smartphone. Actual usage of the step counter was excellent, with patients wearing it for a median (25th-75th percentiles) of 6.3 (5.8-6.8) days per week, which did not change over time (P=.98). The smartphone interface was used less frequently and actual usage of all daily tasks decreased significantly over time (P

Published
2018

25. Recommendations on non-Pharmacological Treatment in Chronic Obstructive Pulmonary Disease From the Spanish COPD Guidelines (GesEPOC 2017)

Author

Pleguezuelos E, Gimeno-Santos E, Hernandez C, Mata M, Palacios L, Pinera P, Molina J, Chiner E, and Miravitlles M

Subjects
Pulmonary rehabilitation, Physical activity, Chronic obstructive pulmonary disease, Integrated care service, Self-care
Abstract

Non-pharmacological treatment is essential in patients with chronic obstructive pulmonary disease (COPD), but this treatment is sometimes not given the importance it deserves. Patients diagnosed with COPD should benefit from comprehensive care services. These services comprise a protocolized set of actions aimed at covering the health needs of the patient, taking into account their environment and circumstances. Pulmonary rehabilitation is one of the essential components of non-pharmacological treatment in comprehensive COPD care services. In the Spanish COPD Guidelines (GesEPOC) 2017, we provided a systematic report of the scientific evidence for pulmonary rehabilitation programs in acute and stable phase disease. Another important issue in the non-pharmacological treatment of COPD is physical activity, and the most essential considerations regarding prescription are described in the GesEPOC guidelines, along with a review of the most effective strategies to ensure adherence. GesEPOC 2017 aims to underline the importance of non-pharmacological treatment as a co-adjuvant to pharmacological treatment. (C) 2018 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

Published
2018

27. Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial

Author

Demeyer, H, Louvaris, Z, Frei, A, Rabinovich, RA, De Jong, C, Gimeno-Santos, E, Loeckx, M, Buttery, SC, Rubio, N, Van der Molen, T, Hopkinson, NS, Vogiatzis, I, Puhan, MA, Garcia-Aymerich, J, Polkey, MI, Troosters, T, On behalf of the Mr Papp PROactive study group and the PROactive consortium, Dobbels, Fabienne, Groningen Research Institute for Asthma and COPD (GRIAC), University of Zurich, and Troosters, T

Subjects
Male, medicine.medical_treatment, INACTIVITY, Respiratory System, law.invention, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, law, Medicine and Health Sciences, Pulmonary Rehabilitation, 030212 general & internal medicine, Patient group, Netherlands, COPD, OUTCOMES, Rehabilitation, Greece, Middle Aged, Prognosis, Telemedicine, 3. Good health, Exercise Therapy, Treatment Outcome, STEPS/DAY, TESTS, Female, Life Sciences & Biomedicine, Switzerland, Pulmonary and Respiratory Medicine, REHABILITATION, medicine.medical_specialty, Pronòstic mèdic, Chronic Obstructive Pulmonary Disease, SOCIETY, Physical activity, 610 Medicine & health, OBSTRUCTIVE PULMONARY-DISEASE, 03 medical and health sciences, medicine, Humans, Pulmonary rehabilitation, In patient, Exercise, Aged, Science & Technology, Intention-to-treat analysis, business.industry, A100, 1103 Clinical Sciences, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), ADULTS, Physical fitness, medicine.disease, United Kingdom, LIFE, 030228 respiratory system, 2740 Pulmonary and Respiratory Medicine, ACTIVITY MONITORS, Spirometry, Physical therapy, business, Condició física
Abstract

RATIONALE: Reduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group. OBJECTIVES: To investigate the effectiveness of a 12-week semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial. METHODS: 343 patients from six centres, encompassing a wide spectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention to treat. MAIN RESULTS: Both groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between-group difference of mean, 95% CI (lower limit - upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p, Rationale Reduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group. Objectives To investigate the effectiveness of a 12-week semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial. Methods 343 patients from six centres, encompassing a wide spectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention to treat. Main results Both groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between-group difference of mean, 95% CI (lower limit – upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p≤0.001). The change in 6-min walk distance was significantly different (13.4, 95% CI (3.40 to 23.5) m, p

Published
2017

28. Heart Rate Recovery After 6-min Walking Test Predicts Acute Exacerbation in COPD

Author

Rodríguez, D.A. Kortianou, E.A. Alison, J.A. Casas, A. Giavedoni, S. Barberan-Garcia, A. Arbillaga, A. Vilaró, J. Gimeno-Santos, E. Vogiatzis, I. Rabinovich, R. Roca, J.

Abstract

Introduction: Abnormalities of autonomic function have been reported in patients with chronic obstructive pulmonary disease (COPD). Our objectives were to identify determinants of abnormal heart rate recovery at 1 min (HRR1) following completion of the 6-min walk test (6MWT) in COPD and to establish whether abnormal HRR1 predicts acute exacerbations (AECOPD). Methods: Hundred one COPD patients (FEV1 (SD) 53 (19) % predicted) were prospectively recruited in a multi-center study. HRR1 after the 6MWT was evaluated as the difference between heart rate at the end of the test and 1 min into the recovery (HRR1). Linear and logistic regression was used to identify predictors of HRR1 and AECOPD, respectively. The best HRR1 cut-off point to predict AECOPD was selected using the receiver operating characteristics (ROC) curves. The follow-up period was 12 months. Results: Distance covered during the 6MWT (m) and DLco (% predicted) were independently associated with HRR1 (r2 = 0.51, p = 0.001). Among several potential covariates, HRR1 emerged as the most significant predictor of AECOPD (Odds ratio [OR], 0.91 per beat of recovery; 95% confidence interval [CI], 0.85–0.97; p = 0.02). The ROC analysis indicated that subjects with HRR1 less than 14 beats (AUC, 0.71 [CI] 0.60–0.80; p = 0.0001) were more likely to suffer an exacerbation during the follow-up period (for HRR1, p = 0.004 [log-rank test]). Conclusions: HRR1 after the 6MWT is an independent predictor factor for AECOPD. Further studies are warranted to examine the physiological mechanisms associating a delayed HRR and acute exacerbations in COPD patients. © 2017, Springer Science+Business Media, LLC.

Published
2017

29. Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: A multicentre randomised controlled trial

Author

Demeyer, H. Louvaris, Z. Frei, A. Rabinovich, R.A. De Jong, C. Gimeno-Santos, E. Loeckx, M. Buttery, S.C. Rubio, N. Van Der Molen, T. Hopkinson, N.S. Vogiatzis, I. Puhan, M.A. Garcia-Aymerich, J. Polkey, M.I. Troosters, T.

Abstract

Rationale Reduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group. Objectives To investigate the effectiveness of a 12- week semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial. Methods 343 patients from six centres, encompassing a wide spectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention to treat. Main results Both groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between-group difference of mean, 95% CI (lower limit - upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/ day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p≤0.001). The change in 6-min walk distance was significantly different (13.4, 95% CI (3.40 to 23.5) m, p

Published
2017

30. Can health status questionnaires be used as a measure of physical activity in COPD patients?

Author

Demeyer, H, Dueñas-Espín, I, De Jongh, C, Louvaris, Z, Hornikx, M, Gimeno-Santos, E, Loeckx, M, Vogiatzis, I, Janssens, W, Hopkinson, NS, Rabinovich, RA, Karlsson, N, Garcia-Aymerich, J, Troosters, T, PROactive consortium, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
Male, Pulmonary and Respiratory Medicine, Gerontology, Copd patients, Health Status, Respiratory System, Psychological intervention, Physical activity, OBSTRUCTIVE PULMONARY-DISEASE, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Health care, Humans, Medicine, In patient, 030212 general & internal medicine, Exercise, Aged, Sedentary lifestyle, business.industry, 11 Medical And Health Sciences, A300, medicine.disease, FRAMEWORK, Obstructive lung disease, 3. Good health, respiratory tract diseases, LIFE, 030228 respiratory system, FUNCTIONAL STATUS, Female, Basic needs, business, PROactive consortium
Abstract

Acting to address the amount of physical activity of patients with chronic obstructive pulmonary disease (COPD) is recommended as part of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations [1]. A level lower than approximately 5000 steps for day (sedentary lifestyle index) is associated with significantly increased health risks [2, 3]. Actively screening to identify patients below this threshold could be an important step towards targeting interventions to increase physical activity. Potential screening tools include activity monitors (objective assessment) or self-reported questionnaires (subjective assessment) to measure the amount of physical activity [4]. The latter method, which is feasible in clinical practice, may not result in an accurate representation in an individual patient, as questionnaire responses tend to misclassify physical activity [5]. Although more accurate and widely used in research, activity monitoring is not yet commonly included in patients' routine assessment. Several health status questionnaires in routine clinical use contain a domain or dimension related to physical activity [6]. In the analytical framework of Leidy [7], functional performance has been defined as the physical, psychological, social, occupational and spiritual activities that people actually do in the normal course of their lives to meet basic needs, fulfil usual roles, and maintain their health and wellbeing. A review by Kocks et al . [8] proposed that these questionnaires could be used in the measurement of functional performance (defined as “what a patient is actually doing”) and that this would be a more practical alternative to physical activity monitoring. Whether this approach is sufficiently valid as a representation of physical activity levels in clinical practice remains to be established. Health status questionnaires provide only limited insight into the physical activity of patients with COPD The PROactive Consortium members are as follows. Nathalie Ivanoff: Almirall, Barcelona, Spain; Niklas Karlsson and Solange Corriol-Rohou: AstraZeneca AB, Molndal, Sweden; Ian Jarrod: British Lung Foundation, London, UK; Damijen Erzen: Boehringer Ingelheim, Nieder-Ingelheim, Germany; Mario Scuri and Roberta Montacchini: Chiesi Farmaceutici S.A. Parma, Italy; Paul McBride: Choice Healthcare Solutions, Hitchin, UK; Nadia Kamel: European Respiratory Society, Lausanne, Switzerland; Margaret Tabberer: GlaxoSmithKline, Uxbridge, UK; Thierry Troosters, Wim Janssens and Fabienne Dobbels,: Katholieke Universiteit Leuven, Leuven, Belgium; Judith Garcia-Aymerich, Municipal Institute of Medical Research, Barcelona, Spain; Pim de Boer: Netherlands Lung Foundation, Amersfoort, The Netherlands; Karoly Kulich and Alastair Glendenning: Novartis, Basel, Switzerland; Michael I. Polkey and Nick S. Hopkinson: Royal Brompton and Harefield NHS Foundation Trust, London, UK; Ioannis Vogiatzis: Thorax Research Foundation, Athens, Greece; Enkeleida Nikai: UCB, Brussels, Belgium; Thys van der Molen and Corina De Jong: University Medical Center, Groningen, The Netherlands; Roberto A. Rabinovich and Bill MacNee: University of Edinburgh, Edinburgh, UK; Milo A. Puhan and Anja Frei: University of Zurich, Zurich, Switzerland.

Published
2016

33. Physical activity characteristics across GOLD quadrants depend on the questionnaire used

Author

Demeyer, H. Gimeno-Santos, E. Rabinovich, R.A. Hornikx, M. Louvaris, Z. De Boer, W.I. Karlsson, N. De Jong, C. Van Der Molen, T. Vogiatzis, I. Janssens, W. Garcia-Aymerich, J. Troosters, T. Polkey, M.I.

Abstract

Background: The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient's distribution in relation to the questionnaire used. Methods: 136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis. Results: GOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p

Published
2016

34. The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease

Author

Gimeno-Santos, E, Raste, Y, Demeyer, H, Louvaris, Z, de Jong, C, Rabinovich, RA, Hopkinson, NS, Polkey, MI, Vogiatzis, I, Tabberer, M, Dobbels, F, Ivanoff, N, de Boer, WI, van der Molen, T, Kulich, K, Serra, I, Basagaña, X, Troosters, T, Puhan, MA, Karlsson, N, Garcia-Aymerich, J, PROactive consortium, Groningen Research Institute for Asthma and COPD (GRIAC), University of Zurich, and Garcia-Aymerich, Judith

Subjects
Male, SELECTION, Pulmons -- Malalties obstructives, Psychometrics, Intraclass correlation, Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, Quality of life, Surveys and Questionnaires, Medicine and Health Sciences, Medicine, REPORTED OUTCOMES, Reliability (statistics), COPD, Cross-Over Studies, Middle Aged, Confirmatory factor analysis, C900, Europe, Female, HEALTH, Algorithms, Pulmonary and Respiratory Medicine, medicine.medical_specialty, 610 Medicine & health, Motor Activity, VALIDATION, Cronbach's alpha, Humans, VALIDITY, Aged, INDACATEROL, Rasch model, business.industry, MEDICINE, Reproducibility of Results, Original Articles, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), medicine.disease, QUESTIONNAIRES, B900, RESPONSE THEORY, DAILY-LIFE, 2740 Pulmonary and Respiratory Medicine, Physical therapy, Quality of Life, business, Factor Analysis, Statistical
Abstract

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD. Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts. 236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled “amount” and “difficulty”. After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test–retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r, Both PROactive hybrid tools are simple, valid, and reliable measures of physical activity in COPD patients http://ow.ly/LJqP8

Published
2015
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35. Systematic Review on the Definition of Allergic Diseases in Children: The MeDALL Study

Author

Pinart, M, Albang, R, Maier, D, Duran-Tauleria, E, Mena, G, Gimeno-Santos, E, Sola, I, Garcia-Aymerich, J, Guerra, S, Stein, RT, Benet, M, Carlsen, KH, Herr, M, Jacquemin, B, Momas, I, Pin, I, Ranciere, F, Smit, HA, Varraso, R, Bonfill, X, Keil, T, Bousquet, J, and Anto, JM

Subjects
Phenotype, Urticaria, Allergy, Eczema, Disease definition, Anaphylaxis, Asthma, Rhinitis
Abstract

Background: During the last decades, a large number of phenotypes and disease classifications of allergic diseases have been proposed. Despite the heterogeneity across studies, no systematic review has been conducted on phenotype classification and the criteria that define allergic diseases. We aimed to identify clinically expressed, population-based phenotypes of allergic diseases and their interrelationships, to explore disease heterogeneity and to evaluate the measurements employed in disease diagnosis. Methods: We conducted a search of MEDLINE up to December 2012, to identify relevant original studies published in the English language that examine at least one objective of this systematic review in subjects aged 0-18 years. The screening of titles and abstracts and the extraction of data were conducted independently by two reviewers. Results: From a total of 13,767 citations, 197 studies met the criteria for inclusion, with 54% being cohort studies. Allergic diseases were studied as a single entity in 55% (109/197) of the studies or in the context of multimorbidity in 45%. Asthma accounted for 81.7% of the studies examining single diseases. Overall, up to 33 different phenotypes of allergic disease were reported. Transient early, late-onset and persistent wheeze were the most frequently reported phenotypes. Most studies (78%) used questionnaires. The skin-prick test was the preferred measurement of sensitization (64%). Spirometry and bronchial hyperresponsiveness were assessed in one third of the studies, peak flow rate in 8.6% and disease severity in 35%. Conclusions: Studies reporting phenotypes of allergic diseases in children are highly heterogeneous and often lack objective phenotypical measures. A concerted effort to standardize methods and terminology is necessary. (C) 2015 S. Karger AG, Basel

Published
2015

37. An official European respiratory society statement on physical activity in COPD

Author

Watz, H. Pitta, F. Rochester, C.L. Garcia-Aymerich, J. ZuWallack, R. Troosters, T. Vaes, A.W. Puhan, M.A. Jehn, M. Polkey, M.I. Vogiatzis, I. Clini, E.M. Toth, M. Gimeno-Santos, E. Waschki, B. Esteban, C. Hayot, M. Casaburi, R. Porszasz, J. McAuley, E. Singh, S.J. Langer, D. Wouters, E.F.M. Magnussen, H. Spruit, M.A.

Abstract

This European Respiratory Society (ERS) statement provides a comprehensive overview on physical activity in patients with chronic obstructive pulmonary disease (COPD). A multidisciplinary Task Force of experts representing the ERS Scientific Group 01.02 ''Rehabilitation and Chronic Care'' determined the overall scope of this statement through consensus. Focused literature reviews were conducted in key topic areas and the final content of this Statement was agreed upon by all members. The current knowledge regarding physical activity in COPD is presented, including the definition of physical activity, the consequences of physical inactivity on lung function decline and COPD incidence, physical activity assessment, prevalence of physical inactivity in COPD, clinical correlates of physical activity, effects of physical inactivity on hospitalisations and mortality, and treatment strategies to improve physical activity in patients with COPD. This Task Force identified multiple major areas of research that need to be addressed further in the coming years. These include, but are not limited to, the disease-modifying potential of increased physical activity, and to further understand how improvements in exercise capacity, dyspnoea and self-efficacy following interventions may translate into increased physical activity. The Task Force recommends that this ERS statement should be reviewed periodically (e.g. every 5-8 years). © 2014 ERS.

Published
2014

38. An Official ERS Statement on Physical Activity in Chronic Obstructive Pulmonary Disease

Author

Watz, H, Pitta, F, Rochester, C, Garcia Aymerich, J, Zuwallack, R, Troosters, T, Vaes, A, Puhan, M, Jehn, M, Polkey, M, Vogiatzis, I, Clini, Enrico, Tooth, M, Gimeno Santos, E, Waschki, B, Esteban, C, Hayot, M, Casaburi, R, Porszasz, J, Mcauley, E, Singh, S, Langer, D, Wouters, E, Magnussen, H, and Spruit, M. A.

Subjects
COPD, physical activity, pulmonary rehabilitation
Published
2014

39. Severe Chronic Allergic (and related) Diseases: a uniform approach- a MeDALL- GA(2)LEN-ARIA Position Paper

Author

WHO Collaborating Center for Asthma, Rhinitis, Bousquet, J, Anto, Jm, Demoly, P, Schünemann, Hj, Togias, A, Akdis, M, Auffray, C, Bachert, C, Bieber, T, Bousquet, Pj, Carlsen, Kh, Casale, Tb, Cruz, Aa, Keil, T, Lodrup Carlsen KC, Maurer, M, Ohta, K, Papadopoulos, Ng, Roman Rodriguez, M, Samolinski, B, Agache, I, Andrianarisoa, A, Ang, Cs, Annesi Maesano, I, Ballester, F, Baena Cagnani CE, Basagaña, X, Bateman, Ed, Bel, Eh, Bedbrook, A, Beghe', Bianca, Beji, M, Ben Kheder, A, Benet, M, Bennoor, Ks, Bergmann, Kc, Berrissoul, F, Bindslev Jensen, C, Bleecker, Er, Bonini, S, Boner, Al, Boulet, Lp, Brightling, Ce, Brozek, Jl, Bush, A, Busse, Ww, Camargos, Pa, Canonica, Gw, Carr, W, Cesario, A, Chen, Yz, Chiriac, Am, Costa, Dj, Cox, L, Custovic, A, Dahl, R, Darsow, U, Didi, T, Dolen, Wk, Douagui, H, Dubakiene, R, El Meziane, A, Fonseca, Ja, Fokkens, Wj, Fthenou, E, Gamkrelidze, A, Garcia Aymerich, J, Gerth van Wijk, R, Gimeno Santos, E, Guerra, S, Haahtela, T, Haddad, H, Hellings, Pw, Hellquist Dahl, B, Hohmann, C, Howarth, P, Hourihane, Jo, Humbert, M, Jacquemin, B, Just, J, Kalayci, O, Kaliner, Ma, Kauffmann, F, Kerkhof, M, Khayat, G, Koffi N'Goran, B, Kogevinas, M, Koppelman, Gh, Kowalski, Ml, Kull, I, Kuna, P, Larenas, D, Lavi, I, Le, Lt, Lieberman, P, Lipworth, B, Mahboub, B, Makela, Mj, Martin, F, Martinez, Fd, Marshall, Gd, Mazon, A, Melen, E, Meltzer, Eo, Mihaltan, F, Mohammad, Y, Mohammadi, A, Momas, I, Morais Almeida, M, Mullol, J, Muraro, A, Naclerio, R, Nafti, S, Namazova Baranova, L, Nawijn, Mc, Nyembue, Td, Oddie, S, O'Hehir, Re, Okamoto, Y, Orru, Mp, Ozdemir, C, Ouedraogo, Gs, Palkonen, S, Panzner, P, Passalacqua, G, Pawankar, R, Pigearias, B, Pin, I, Pinart, M, Pison, C, Popov, Ta, Porta, D, Postma, Ds, Price, D, Rabe, Kf, Ratomaharo, J, Reitamo, S, Rezagui, D, Ring, J, Roberts, R, Roca, J, Rogala, B, Romano, A, Rosado Pinto, J, Ryan, D, Sanchez Borges, M, Scadding, Gk, Sheikh, A, Simons, Fe, Siroux, V, Schmid Grendelmeier PD, Smit, Ha, Sooronbaev, T, Stein, Rt, Sterk, Pj, Sunyer, J, Terreehorst, I, Toskala, E, Tremblay, Y, Valenta, R, Valeyre, D, Vandenplas, O, van Weel, C, Vassilaki, M, Varraso, R, Viegi, G, Wang, Dy, Wickman, M, Williams, D, Wöhrl, S, Wright, J, Yorgancioglu, A, Yusuf, Om, Zar, Hj, Zernotti, Me, Zidarn, M, Zhong, N, Zuberbier, T., Beghe', B., Fthenou, E., Boudier, Anne, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), IMIM-Hospital del Mar, Generalitat de Catalunya, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, CIBER Epidemiologia y Salud Publica, CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra [Barcelona] (UPF), WHO Collaborating Center for Asthma and Rhinitis, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations, Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Génomique fonctionnelle et biologie systémique pour la santé, Institut des Sciences Biologiques du CNRS, Upper Airway Research Laboratory (URL), Ghent University Hospital, Department of Dermatology and Allergy, VU University Medical Center [Amsterdam], Department of Paediatrics, University of Oslo (UiO)-Oslo University Hospital [Oslo], Division of Allergy and Immunology, Department of Medicine, Creighton University, ProAR - FMB, Federal University of Bahia School of Medicine, Epidemiology and Health Economics, Instittute of Social Health-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of Dermatology, Medical School-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Allergy Department, 2nd Pediatric Clinic, Son Pisa Primary Care Centre, IB-Salut Balearic Health Service, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Department of Allergy and Clinical Immunology, Faculty of Medicine-Transylvania University, Public Hospital Medical Service, Ministry of Health [Mozambique], Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Public Health Research (CSISP), University of Valencia, Respiratory Medicine, Università degli studi di Genova = University of Genoa (UniGe)-School of Specialization, Faculty of Medicine, Catholic University, Health Sciences Faculty, University of Cape Town, Department of Pulmonology, University of Amsterdam [Amsterdam] (UvA)-Academic Medical Centre, Divisions of Human Genetics Infection, Inflammation and Repair, University of Southampton-School of Medicine, Service de Pneumologie Allergologie, Hôpital La Rabta [Tunis], Service de Pneumologie, Hôpital Abderrahmen Mami, National Asthma Centre, National Institute of Diseases of the Chest and Hospital (NIDCH), Pneumologie / Anesthésie - réanimation / Oxygénothérapie, Hôpital AKS Phnom Penh-Hôpital Provincial de Siemreap, Department of Dermatology and Allergy Center, Odense University Hospital, Center for Genomics and Personalized Medicine, Wake Forest University, Institute of Neurobiology and Molecular Medicine, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli studi di Verona = University of Verona (UNIVR), Institut de cardiologie et de pneumologie, Université Laval [Québec] (ULaval)-Centre Hospitalier de Laval (CH Laval), Department of Respiratory Medicine and Thoracic Surgery, University of Leicester-Institute for Lung Health, Department of Paediatric Respiratory Medicine, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], Department of Medicine, University of Wisconsin School of Medicine and Public Health, Department of Pediatrics, Universidade Federal de Minas Gerais [Belo Horizonte] (UFMG)-Medical School, Allergy & Respiratory Diseases, Università degli studi di Genova = University of Genoa (UniGe)-Department of Internal Medicine (DIMI), Allergy & Asthma Associates, University of California [Irvine] (UC Irvine), University of California (UC)-University of California (UC), Deputy Scientific Director, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Department of Thoracic Surgery, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), National Cooperative Group of Pediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Service des Premiers Soins, Université Montpellier 1 (UM1), Osteopathic College of Medicine, Nova Southeastern University (NSU), Respiratory Research Group, University of Manchester [Manchester]-School of Translational Medicine, Department of Respiratory Diseases, Aarhus University Hospital, Department of Dermatology and Allergy Biederstein, Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Service de pneumologie, Centre hospitalier de la région d'Annecy, Service de pneumo-allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Allergy Centre, Vilnius University Antakalnis Hospital, Société Marocaine des Maladies Respiratoires, Centre of Respiratory Diseases and Allergy-Centre commercial Nadia, Allergy Division, Hospital S. João-Centre for Research in Health Technologies and Information Systems (CINTESIS)-Biostatistics and Medical Informatics Department-Porto University Medical School, Department of Otorhinolaryngology, Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA), Department of Social Medicine, University of Crete [Heraklion] (UOC)-Faculty of Medicine, Health Care, Minister Of Labour-Ministry of Labor, Health and Social Affairs, Section of Allergology, Erasmus Medical Centre, Epidemiology and Biostatistics Division, University of Arizona-Associate Research Scientist, Respiratory Sciences-Arizona Respiratory Center, Helsinki University Hospital-Skin and Allergy Hospital, Centre Hospitalier de Bigorre [Tarbes]-Association Franco-Libanaise de Pneumologie (AFLP), Department of Otorhinolaryngology, Head, and Neck Surgery, University Hospital Leuven, Engineering and the Environment, University of Southampton, Paediatrics and Child Health, University College Cork (UCC), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Pediatric Allergy and Asthma Unit, Ihsan Dogramaci Children's Hospital-Hacettepe University School of Medicine, Institute for Asthma and Allergy, George Washington University Medical School, Department of Epidemiology, University of Groningen [Groningen]-University Medical Center Groningen [Groningen] (UMCG)-Groningen Research Institute for Asthma and COPD (GRIAC), Université Saint-Joseph de Beyrouth (USJ)-Faculté de Médecine-Hôtel-Dieu de France, Service des Maladies Respiratoires, CHU de Cocody-UFR des Sciences Médicales, Pediatric Pulmonology, Allergology & Epidemiology, University of Groningen [Groningen]-University Medical Center Groningen [Groningen] (UMCG)-Beatrix Children's Hospital-Groningen Research Institute for Asthma and COPD, Department of Clinical Immunology and Allergy, Medical University of Łódź (MUL)-Faculty ot Medicine, Centre for Allergy Research, Karolinska Institutet [Stockholm], Department of Clinical Science and Education, Division of Internal Medicine, Asthma and Allergy, Medical University of Łódź (MUL)-Barlicki University Hospital, Hospital Medica Sur, Physiology Department, University of Medicine and Pharmacy, Division of Allergy Immunology, Department of Medicine-The University of Tennessee Health Science Center [Memphis] (UTHSC), university of dundee asthma - allergic rhinitis - COPD - beta-2-adrenoceptor, University of Dundee, Pulmonary and allergy unit, American University of Sharjah-Rashid Hospital-Dubai Health Authority (DHA), Association Franco-Vietnamienne de Pneumologie (AFVP), Centre Hospitalier de Compiègne (CHC), Arizona Respiratory Center, Department of Medicine, Clinical Immunology and Allergy, University of Mississippi Medical Center (UMMC), Institute of Environmental Medicine, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, Allergy & Asthma Medical Group & Research Center, University of California [San Diego] (UC San Diego), Pneumology Department, Marius Nasta Institute of Pneumology, Department of Internal Medicine, Tishreen University School of Medicine, Association Franco-Marocaine de Pathologie Thoracique (AFMAPATH), Collège National des Pneumologues Marocains, Epidémiologie Environnementale : Impact Sanitaire des Pollutions (EA 4064), Université Paris Descartes - Paris 5 (UPD5), Immunoallergy Department, Hospital CUF Descobertas, Rhinology Unit & Smell Clinic, Universitat de Barcelona (UB)-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Department of Medicine-Hospital Clinic-ENT Department, Allergy Unit, Università degli Studi di Padova = University of Padua (Unipd)-Department of Paediatrics, Section of Otolaryngology-Head & Neck Surgery (OHNS), University of Chicago, Clinique des maladies respiratoires, centre hospitalo-universitaire Mustapha Pacha d'Alger (CHUMA), Scientific Center for Children's Health, Russian Academy of Medical Sciences (RAMS), Laboratory of Allergology and Pulmonary Diseases, University of Groningen [Groningen]-University Medical Center Groningen [Groningen] (UMCG)-Department of Pathology and Medical Biology-GRIAC Research Institute, ENT Department, University of Kinshasa (UNIKIN), Bradford Neonatology, Bradford Teaching Hospitals NHS Foundation Trust-Bradford Institute for Health Research, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital-Monash University Building, AMREP, Chiba University Hospital, Asthme Rhinite allergique, Pharmacie, Division of Pediatric Allergy and Immunology, marmara university, Pédiatrie, Centre Hospitalier National Pédiatrique Charles de Gaulle (CHNP-CDG), European Federation of Allergy (EFA), Airways Diseases Patients' Associations, Department of Allergology and Clinical Immunology, Charles University [Prague] (CU)-Medical Faculty in Pilsen, Immunopharmacology, Nippon Medical School-Medical Research Council Clinical, Laboratoire du Sommeil et de l'Effort, Société de Pneumologie de Langue Française (SPLF)-Clinique St George, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinic of Allergy and Asthma, Medical University Sofia-Alexander's University Hospital, Regional Health Service - Lazio, Primary Care Respiratory Medicine, University of Aberdeen-Department of General Practice and Primary Care-General Practice Airways Group (GPIAG), Department of Pulmonary Medicine, Leiden University Medical Center (LUMC), Pneumalgia, Centre Hospitalier Regional-Espace Francophone de Pneumologie (EFP)-Société de Pneumologie de l'Océan Indien (SPOI), Association Franco-Algérienne de Pneumologie (AFAP), Espace Francophone de pneumologie de la SPLF, Department of Pneumology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clínic de Barcelona-Institut Clínic del Tórax (ICT)-CIBER de Enfermedades Respiratorias (CIBERES)-University of Barcelona, Allergology and Clinical Immunology, Medical University of Silesia (SUM)-Chair and Clinical Department of Internal Diseases, UCSC-Allergy Unit, Complesso Integrato Columbus-Department of Internal Medicine and Geriatrics, Hospital da Luz, Medical Centre, Woodbrook Medical Centre, Research Fellow, University of Aberdeen-Department of General Practice, Centro Médico Docente La Trinidad, Department of Pharmacology, University College of London [London] (UCL)-The Royal National Throat, Nose and Ear Hospital, Primary Care Research & Development, University of Edinburgh-Centre for Population Health Sciences, Section of Allergy & Clinical Immunology, University of Manitoba [Winnipeg]-Department of Pediatrics & Child Health, Allergy Unit - Department of Dermatology, Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], National Centre of Cardiology and Internal Medicine, Ministry of Health Kyrgyz Republic, School of Medicine, Pontifícia Universidade Católica, Department of ENT and Pediatrics, Finnish Institute of Occupational Health, Department of Obstetrics and Gynaecology, Université Laval [Québec] (ULaval)-Faculty of Medicine, Christian Doppler Laboratory for Allergy Research, Medizinische Universität Wien = Medical University of Vienna-Division of Immunopathology-Department of Pathophysiology and Allergy Research-Center for Pathophysiology, Infectiology and Immunology, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Department of Chest Medicine, Mont-Godinne Hospital-Catholic University of Louvain de Mont-Godinne, Department of Primary and Community Care, Radboud University Medical Center [Nijmegen], Epidemiology Unit, National Research Council (CNR)-Institute of Biomedicine and Molecular Immunology (IBIM), Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Department of Otolaryngology, National University of Singapore (NUS)-Yong Loo Lin School of Medicine, Karolinska Institutet [Stockholm]-Sachs' Children's Hospital, GLP Analytical Facility, School of Pharmacy, Department of Dermatology Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna (MUW), Celal Bayar University School of Medicine, Allergy and Asthma Clinics, The Allergy and Asthma Institute, Department of Paediatrics and Child Health, Respiratory and Allergic Diseases, University Clinic of Respiratory and Allergic Diseases Golnik, State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases-Guangzhou Medical College, Secretary General of the Global Allergy and Asthma European Network (GA2LEN), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], In collaboration with the WHO Collaborating Center for Asthma and Rhinitis, University of Genoa (UNIGE)-School of Specialization, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II, University of Verona (UNIVR), Medical School-Federal University of Minas Gerais, University of Genoa (UNIGE)-Department of Internal Medicine (DIMI), University of California [Irvine] (UCI), University of California-University of California, Catholic University Rome, University of Amsterdam [Amsterdam] (UvA)-Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Centre Hospitalier de Bigorre (Tarbes)-Association Franco-Libanaise de Pneumologie (AFLP), CUF-Descobertas Hospital, Universita degli Studi di Padova-Department of Paediatrics, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Centro Medico-Docente La Trinidad, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]-Instittute of Social Health, Department of Internal Medicine (DIMI)-University of Genoa (UNIGE), Medical University of Silesia-Chair and Clinical Department of Internal Diseases, Dermatology, Internal Medicine, Immunology, Hôpital Arnaud de Villeneuve, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for Research in Environmental Epidemiology ( CREAL ), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Universitat Pompeu Fabra [Barcelona], WHO(OMS), Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), National Institute of Allergy and Infectious Diseases [Bethesda], National Institutes of Health ( NIH ), Swiss Institute of Allergy and Asthma Research ( SIAF ), University of Zürich [Zürich] ( UZH ), Upper Airway Research Laboratory ( URL ), University Medical Center, University of Oslo ( UiO ) -Oslo University Hospital, Charite-Universitatsmedizin Berlin [Berlin]-Instittute of Social Health, Medical School-Charité - University Medicine Berlin, Medical University of Warsaw-Faculté de Pharmacie de Paris, Ministry of Health, Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for Public Health Research ( CSISP ), University of Genoa ( UNIGE ) -School of Specialization, University of Amsterdam [Amsterdam] ( UvA ) -Academic Medical Centre, University of Southampton [Southampton]-School of Medicine, Hôpital La Rabta [Tunis), Wake Forest University Health Sciences, CNR, Rome, Italy and Department of Medicine-Second University of Naples, Università degli Studi di Verona, Université Laval-l'Hôpital Laval, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, University of Genoa ( UNIGE ) -Department of Internal Medicine (DIMI), Southern California Research, Université Montpellier 1 ( UM1 ), Nova Southeastern University, Technische Universität München [München] ( TUM ), Academic Medical Center [Amsterdam] ( AMC ), University of Amsterdam [Amsterdam] ( UvA ) -University of Amsterdam [Amsterdam] ( UvA ), University of Crete ( UOC ) -Faculty of Medicine, University of Southampton [Southampton], UUniversity College Cork - National University of Ireland, Cork (UCC), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Antoine Béclère, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], University of Groningen [Groningen]-University Medical Center Groningen-Groningen Research Institute for Asthma and COPD (GRIAC), Université Saint-Joseph de Beyrouth ( USJ ) -Faculté de Médecine-Hôtel-Dieu de France, University of Groningen [Groningen]-University Medical Center Groningen-Beatrix Children's Hospital-Groningen Research Institute for Asthma and COPD, Medical University of Łódź ( MUL ) -Faculty ot Medicine, Medical University of Łódź ( MUL ) -Barlicki University Hospital, Department of Medicine-University of Tennessee College for Medicine, Association Franco-Vietnamienne de Pneumologie ( AFVP ), University of Mississippi Medical Center, University of California [San Diego] ( UC San Diego ), Association Franco-Marocaine de Pathologie Thoracique ( AFMAPATH ), Epidémiologie Environnementale : Impact Sanitaire des Pollutions ( EA 4064 ), Université Paris Descartes - Paris 5 ( UPD5 ), Universitat de Barcelona ( UB ) -Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Department of Medicine-Hospital Clinic-ENT Department, Section of Otolaryngology-Head & Neck Surgery ( OHNS ), University of Groningen [Groningen]-University Medical Center Groningen-Department of Pathology and Medical Biology-GRIAC Research Institute, University Hospital of Kinshasa, European Federation of Allergy ( EFA ), Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Bioenergétique fondamentale et appliquée ( LBFA ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Department of General Practice and Primary Care-General Practice Airways Group (GPIAG)-University of Aberdeen, Association Franco-Algérienne de Pneumologie ( AFAP ), Department of General Practice-University of Aberdeen, University College of London [London] ( UCL ) -The Royal National Throat, Nose and Ear Hospital, University Medical Center Utrecht, Faculty of Medicine-Laval University [Québec], Medical University of Vienna-Division of Immunopathology-Department of Pathophysiology and Allergy Research-Center for Pathophysiology, Infectiology and Immunology, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, National University of Singapore ( NUS ) -Yong Loo Lin School of Medicine, Department of Dermatology Division of Immunology, Allergy and Infectious Diseases ( DIAID ), Secretary General of the Global Allergy and Asthma European Network ( GA2LEN ), Network of Excellence, Charité - Universitätsmedizin Berlin, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (BIHR), Universiteit Leiden-Universiteit Leiden, and Medizinische Universität Wien = Medical University of Vienna

Subjects
MESH: Asthma, severity, MESH: Comorbidity, Comorbidity, Severity of Illness Index, urticaria, MESH : Chronic Disease, MESH: Practice Guidelines as Topic, MESH : Dermatitis, Atopic, MESH: Urticaria, risk, 216-31 [Rhinitis, atopy, allergen Int Arch Allergy Immunol. 2012,158(3)], atopic dermatitis, MESH : Rhinitis, MESH: Rhinitis, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Effective primary care and public health [NCEBP 7], Immunoglobulin E - Asthma - Rhinitis - Rhinosinusitis - Urticaria - Atopic dermatitis, MESH : Practice Guidelines as Topic, Practice Guidelines as Topic, MESH : Comorbidity, MESH : Severity of Illness Index, IgE, MESH: Sinusitis, MESH : Urticaria, MESH: Hypersensitivity, macromolecular substances, MESH : Asthma, Dermatitis, Atopic, rhinitis, SDG 3 - Good Health and Well-being, MESH: Dermatitis, Atopic, MESH: Severity of Illness Index, Hypersensitivity, Humans, Sinusitis, rhinosinusitis, MESH : Hypersensitivity, MESH: Humans, MESH: Chronic Disease, MESH : Humans, Asthma, Atopic dermatitis, Immunoglobulin E, Rhinitis, Rhinosinusitis, Urticaria, asthma, allergy, MESH : Sinusitis, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Chronic Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, control
Abstract

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies. Copyright (C) 2012 S. Karger AG, Basel

Published
2012
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40. Severe chronic allergic (and related) diseases: A uniform approach - A MeDALL - GA2 LEN - ARIA position paper

Author

Bousquet, J. Anto, J.M. Demoly, P. Schünemann, H.J. Togias, A. Akdis, M. Auffray, C. Bachert, C. Bieber, T. Bousquet, P.J. Carlsen, K.H. Casale, T.B. Cruz, A.A. Keil, T. Lodrup Carlsen, K.C. Maurer, M. Ohta, K. Papadopoulos, N.G. Roman Rodriguez, M. Samolinski, B. Agache, I. Andrianarisoa, A. Ang, C.S. Annesi-Maesano, I. Ballester, F. Baena-Cagnani, C.E. Basagaña, X. Bateman, E.D. Bel, E.H. Bedbrook, A. Beghé, B. Beji, M. Ben Kheder, A. Benet, M. Bennoor, K.S. Bergmann, K.C. Berrissoul, F. Bindslev Jensen, C. Bleecker, E.R. Bonini, S. Boner, A.L. Boulet, L.P. Brightling, C.E. Brozek, J.L. Bush, A. Busse, W.W. Camargos, P.A.M. Canonica, G.W. Carr, W. Cesario, A. Chen, Y.Z. Chiriac, A.M. Costa, D.J. Cox, L. Custovic, A. Dahl, R. Darsow, U. Didi, T. Dolen, W.K. Douagui, H. Dubakiene, R. El-Meziane, A. Fonseca, J.A. Fokkens, W.J. Fthenou, E. Gamkrelidze, A. Garcia-Aymerich, J. Van Wijk, R.G. Gimeno-Santos, E. Guerra, S. Haahtela, T. Haddad, H. Hellings, P.W. Hellquist-Dahl, B. Hohmann, C. Howarth, P. Hourihane, J.O. Humbert, M. Jacquemin, B. Just, J. Kalayci, O. Kaliner, M.A. Kauffmann, F. Kerkhof, M. Khayat, G. Koffi N'Goran, B. Kogevinas, M. Koppelman, G.H. Kowalski, M.L. Kull, I. Kuna, P. Larenas, D. Lavi, I. Le, L.T. Lieberman, P. Lipworth, B. Mahboub, B. Makela, M.J. Martin, F. Martinez, F.D. Marshall, G.D. Mazon, A. Melen, E. Meltzer, E.O. Mihaltan, F. Mohammad, Y. Mohammadi, A. Momas, I. Morais-Almeida, M. Mullol, J. Muraro, A. Naclerio, R. Nafti, S. Namazova-Baranova, L. Nawijn, M.C. Nyembue, T.D. Oddie, S. O'Hehir, R.E. Okamoto, Y. Orru, M.P. Ozdemir, C. Ouedraogo, G.S. Palkonen, S. Panzner, P. Passalacqua, G. Pawankar, R. Pigearias, B. Pin, I. Pinart, M. Pison, C. Popov, T.A. Porta, D. Postma, D.S. Price, D. Rabe, K.F. Ratomaharo, J. Reitamo, S. Rezagui, D. Ring, J. Roberts, R. Roca, J. Rogala, B. Romano, A. Rosado-Pinto, J. Ryan, D. Sanchez-Borges, M. Scadding, G.K. Sheikh, A. Simons, F.E.R. Siroux, V. Schmid-Grendelmeier, P.D. Smit, H.A. Sooronbaev, T. Stein, R.T. Sterk, P.J. Sunyer, J. Terreehorst, I. Toskala, E. Tremblay, Y. Valenta, R. Valeyre, D. Vandenplas, O. Van Weel, C. Vassilaki, M. Varraso, R. Viegi, G. Wang, D.Y. Wickman, M. Williams, D. Wöhrl, S. Wright, J. Yorgancioglu, A. Yusuf, O.M. Zar, H.J. Zernotti, M.E. Zidarn, M. Zhong, N. Zuberbier, T.

Subjects
macromolecular substances
Abstract

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies. Copyright © 2012 S. Karger AG, Basel.

Published
2012

41. Validity of activity monitors in health and chronic disease: a systematic review

Author

Van Remoortel, H. Giavedoni, S. Raste, Y. Burtin, C. Louvaris, Z. Gimeno-Santos, E. Langer, D. Glendenning, A. Hopkinson, N.S. Vogiatzis, I. Peterson, B.T. Wilson, F. Mann, B. Rabinovich, R. Puhan, M.A. Troosters, T. Chiesi Farmaceutici, S.A. Brindicci, C. Higenbottam, T. Troosters, T. Dobbels, F. Decramer, M. Tabberer, M.X. Rabinovich, R.A. McNee, W. Vogiatzis, I. Polkey, M. Hopkinson, N. Garcia-Aymerich, J. Puhan, M. Frei, A. van der Molen, T. De Jong, C. de Boer, P. Jarrod, I. McBride, P. Kamel, N. Rudell, K. Wilson, F.J. Ivanoff, N. Kulich, K. Glendenning, A. Karlsson, N.X. Corriol-Rohou, S. Nikai, E. Damijen Erzen

Abstract

The assessment of physical activity in healthy populations and in those with chronic diseases is challenging. The aim of this systematic review was to identify whether available activity monitors (AM) have been appropriately validated for use in assessing physical activity in these groups. Following a systematic literature search we found 134 papers meeting the inclusion criteria; 40 conducted in a field setting (validation against doubly labelled water), 86 in a laboratory setting (validation against a metabolic cart, metabolic chamber) and 8 in a field and laboratory setting. Correlation coefficients between AM outcomes and energy expenditure (EE) by the criterion method (doubly labelled water and metabolic cart/chamber) and percentage mean differences between EE estimation from the monitor and EE measurement by the criterion method were extracted. Random-effects meta-analyses were performed to pool the results across studies where possible. Types of devices were compared using meta-regression analyses. Most validation studies had been performed in healthy adults (n = 118), with few carried out in patients with chronic diseases (n = 16). For total EE, correlation coefficients were statistically significantly lower in uniaxial compared to multisensor devices. For active EE, correlations were slightly but not significantly lower in uniaxial compared to triaxial and multisensor devices. Uniaxial devices tended to underestimate TEE (-12.07 (95%CI; -18.28 to -5.85) %) compared to triaxial (-6.85 (95%CI; -18.20 to 4.49) %, p = 0.37) and were statistically significantly less accurate than multisensor devices (-3.64 (95%CI; -8.97 to 1.70) %, p

Published
2012

42. Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper.

Author

Bousquet, J., Anto, J.M., Demoly, P., Schunemann, H.J., Togias, A., Akdis, M., Auffray, C., Bachert, C., Bieber, T., Bousquet, P.J., Carlsen, K.H., Casale, T.B., Cruz, A.A., Keil, T., Lodrup Carlsen, K.C., Maurer, M., Ohta, K., Papadopoulos, N.G., Roman Rodriguez, M., Samolinski, B., Agache, I., Andrianarisoa, A., Ang, C.S., Annesi-Maesano, I., Ballester, F., Baena-Cagnani, C.E., Basagana, X., Bateman, E.D., Bel, E.H., Bedbrook, A., Beghe, B., Beji, M., Kheder, A. Ben, Benet, M., Bennoor, K.S., Bergmann, K.C., Berrissoul, F., Bindslev Jensen, C., Bleecker, E.R., Bonini, S., Boner, A.L., Boulet, L.P., Brightling, C.E., Brozek, J.L., Bush, A., Busse, W.W., Camargos, P.A., Canonica, G.W., Carr, W., Cesario, A., Chen, Y.Z., Chiriac, A.M., Costa, D.J., Cox, L., Custovic, A., Dahl, R., Darsow, U., Didi, T., Dolen, W.K., Douagui, H., Dubakiene, R., El-Meziane, A., Fonseca, J.A., Fokkens, W.J., Fthenou, E., Gamkrelidze, A., Garcia-Aymerich, J., Gerth van Wijk, R., Gimeno-Santos, E., Guerra, S., Haahtela, T., Haddad, H., Hellings, P.W., Hellquist-Dahl, B., Hohmann, C., Howarth, P., Hourihane, J.O., Humbert, M., Jacquemin, B., Just, J., Kalayci, O., Kaliner, M.A., Kauffmann, F., Kerkhof, M. van de, Khayat, G., Koffi N'Goran, B., Kogevinas, M., Koppelman, G.H., Kowalski, M.L., Kull, I., Kuna, P., Larenas, D., Lavi, I., Le, L.T., Lieberman, P., Lipworth, B., Mahboub, B., Makela, M.J., Martin, F., Martinez, F.D., Marshall, G.D., Fatima Mazon, A. di, Melen, E., Meltzer, E.O., Mihaltan, F., Mohammad, Y., Mohammadi, A., Momas, I., Morais-Almeida, M., Mullol, J., Muraro, A., Naclerio, R., Nafti, S., Namazova-Baranova, L., Nawijn, M.C., Nyembue, T.D., Oddie, S., O'Hehir, R.E., Okamoto, Y., Orru, M.P., Ozdemir, C., Ouedraogo, G.S., Palkonen, S., Panzner, P., Passalacqua, G., Pawankar, R., Pigearias, B., Pin, I., Pinart, M., Pison, C., Popov, T.A., Porta, D., Postma, D.S., Price, D., Rabe, K.F., Ratomaharo, J., Reitamo, S., Rezagui, D., Ring, J., Roberts, R., Roca, J., Rogala, B., Romano, A., Rosado-Pinto, J., Ryan, D., Sanchez-Borges, M., Scadding, G.K., Sheikh, A., Simons, F.E., Siroux, V., Schmid-Grendelmeier, P.D., Smit, H.A., Sooronbaev, T., Stein, R.T., Sterk, P.J., Sunyer, J., Terreehorst, I., Toskala, E., Tremblay, Y., Valenta, R., Valeyre, D., Vandenplas, O., Weel, C. van, Vassilaki, M., Varraso, R., Viegi, G., Wang, D.Y., Wickman, M., Williams, D., Wohrl, S., Wright, J., Yorgancioglu, A., Yusuf, O.M., Zar, H.J., Zernotti, M.E., Zidarn, M., Zhong, N., Zuberbier, T., Bousquet, J., Anto, J.M., Demoly, P., Schunemann, H.J., Togias, A., Akdis, M., Auffray, C., Bachert, C., Bieber, T., Bousquet, P.J., Carlsen, K.H., Casale, T.B., Cruz, A.A., Keil, T., Lodrup Carlsen, K.C., Maurer, M., Ohta, K., Papadopoulos, N.G., Roman Rodriguez, M., Samolinski, B., Agache, I., Andrianarisoa, A., Ang, C.S., Annesi-Maesano, I., Ballester, F., Baena-Cagnani, C.E., Basagana, X., Bateman, E.D., Bel, E.H., Bedbrook, A., Beghe, B., Beji, M., Kheder, A. Ben, Benet, M., Bennoor, K.S., Bergmann, K.C., Berrissoul, F., Bindslev Jensen, C., Bleecker, E.R., Bonini, S., Boner, A.L., Boulet, L.P., Brightling, C.E., Brozek, J.L., Bush, A., Busse, W.W., Camargos, P.A., Canonica, G.W., Carr, W., Cesario, A., Chen, Y.Z., Chiriac, A.M., Costa, D.J., Cox, L., Custovic, A., Dahl, R., Darsow, U., Didi, T., Dolen, W.K., Douagui, H., Dubakiene, R., El-Meziane, A., Fonseca, J.A., Fokkens, W.J., Fthenou, E., Gamkrelidze, A., Garcia-Aymerich, J., Gerth van Wijk, R., Gimeno-Santos, E., Guerra, S., Haahtela, T., Haddad, H., Hellings, P.W., Hellquist-Dahl, B., Hohmann, C., Howarth, P., Hourihane, J.O., Humbert, M., Jacquemin, B., Just, J., Kalayci, O., Kaliner, M.A., Kauffmann, F., Kerkhof, M. van de, Khayat, G., Koffi N'Goran, B., Kogevinas, M., Koppelman, G.H., Kowalski, M.L., Kull, I., Kuna, P., Larenas, D., Lavi, I., Le, L.T., Lieberman, P., Lipworth, B., Mahboub, B., Makela, M.J., Martin, F., Martinez, F.D., Marshall, G.D., Fatima Mazon, A. di, Melen, E., Meltzer, E.O., Mihaltan, F., Mohammad, Y., Mohammadi, A., Momas, I., Morais-Almeida, M., Mullol, J., Muraro, A., Naclerio, R., Nafti, S., Namazova-Baranova, L., Nawijn, M.C., Nyembue, T.D., Oddie, S., O'Hehir, R.E., Okamoto, Y., Orru, M.P., Ozdemir, C., Ouedraogo, G.S., Palkonen, S., Panzner, P., Passalacqua, G., Pawankar, R., Pigearias, B., Pin, I., Pinart, M., Pison, C., Popov, T.A., Porta, D., Postma, D.S., Price, D., Rabe, K.F., Ratomaharo, J., Reitamo, S., Rezagui, D., Ring, J., Roberts, R., Roca, J., Rogala, B., Romano, A., Rosado-Pinto, J., Ryan, D., Sanchez-Borges, M., Scadding, G.K., Sheikh, A., Simons, F.E., Siroux, V., Schmid-Grendelmeier, P.D., Smit, H.A., Sooronbaev, T., Stein, R.T., Sterk, P.J., Sunyer, J., Terreehorst, I., Toskala, E., Tremblay, Y., Valenta, R., Valeyre, D., Vandenplas, O., Weel, C. van, Vassilaki, M., Varraso, R., Viegi, G., Wang, D.Y., Wickman, M., Williams, D., Wohrl, S., Wright, J., Yorgancioglu, A., Yusuf, O.M., Zar, H.J., Zernotti, M.E., Zidarn, M., Zhong, N., and Zuberbier, T.

Abstract

Item does not contain fulltext, Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.

Published
2012

43. Severe chronic allergic (and related) diseases: A uniform approach - A MeDALL - GA 2 LEN - ARIA position paper

Author

UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Bousquet, J., Anto, J.M., Demoly, P., Schünemann, H.J., Togias, A., Akdis, M., Auffray, C., Bachert, C., Bieber, T., Bousquet, P.J., Carlsen, K.H., Casale, T.B., Cruz, A.A., Keil, T., Lodrup Carlsen, K.C., Maurer, M., Ohta, K., Papadopoulos, N.G., Roman Rodriguez, M., Samolinski, B., Agache, I., Andrianarisoa, A., Ang, C.S., Annesi-Maesano, I., Ballester, F., Baena-Cagnani, C.E., Basagaña, X., Bateman, E.D., Bel, E.H., Bedbrook, A., Beghé, B., Beji, M., Ben Kheder, A., Benet, M., Bennoor, K.S., Bergmann, K.C., Berrissoul, F., Bindslev Jensen, C., Bleecker, E.R., Bonini, S., Boner, A.L., Boulet, L.P., Brightling, C.E., Brozek, J.L., Bush, A., Busse, W.W., Camargos, P.A.M., Canonica, G.W., Carr, W., Cesario, A., Chen, Y.Z., Chiriac, A.M., Costa, D.J., Cox, L., Custovic, A., Dahl, R., Darsow, U., Didi, T., Dolen, W.K., Douagui, H., Dubakiene, R., El-Meziane, A., Fonseca, J.A., Fokkens, W.J., Fthenou, E., Gamkrelidze, A., Garcia-Aymerich, J., Van Wijk, R.G., Gimeno-Santos, E., Guerra, S., Haahtela, T., Haddad, H., Hellings, P.W., Hellquist-Dahl, B., Hohmann, C., Howarth, P., Hourihane, J.O., Humbert, M., Jacquemin, B., Just, J., Kalayci, O., Kaliner, M.A., Kauffmann, F., Kerkhof, M., Khayat, G., Koffi N'Goran, B., Kogevinas, M., Koppelman, G.H., Kowalski, M.L., Kull, I., Kuna, P., Larenas, D., Lavi, I., Le, L.T., Lieberman, P., Lipworth, B., Mahboub, B., Makela, M.J., Martin, F., Martinez, F.D., Marshall, G.D., Mazon, A., Melen, E., Meltzer, E.O., Mihaltan, F., Mohammad, Y., Mohammadi, A., Momas, I., Morais-Almeida, M., Mullol, J., Muraro, A., Naclerio, R., Nafti, S., Namazova-Baranova, L., Nawijn, M.C., Nyembue, T.D., Oddie, S., O'Hehir, R.E., Okamoto, Y., Orru, M.P., Ozdemir, C., Ouedraogo, G.S., Palkonen, S., Panzner, P., Passalacqua, G., Pawankar, R., Pigearias, B., Pin, I., Pinart, M., Pison, C., Popov, T.A., Porta, D., Postma, D.S., Price, D., Rabe, K.F., Ratomaharo, J., Reitamo, S., Rezagui, D., Ring, J., Roberts, R., Roca, J., Rogala, B., Romano, A., Rosado-Pinto, J., Ryan, D., Sanchez-Borges, M., Scadding, G.K., Sheikh, A., Simons, F.E.R., Siroux, V., Schmid-Grendelmeier, P.D., Smit, H.A., Sooronbaev, T., Stein, R.T., Sterk, P.J., Sunyer, J., Terreehorst, I., Toskala, E., Tremblay, Y., Valenta, R., Valeyre, D., Vandenplas, Olivier, Van Weel, C., Vassilaki, M., Varraso, R., Viegi, G., Wang, D.Y., Wickman, M., Williams, D., Wöhrl, S., Wright, J., Yorgancioglu, A., Yusuf, O M, Zar, H.J., Zernotti, M.E., Zidarn, M., Zhong, N., Zuberbier, T., UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Bousquet, J., Anto, J.M., Demoly, P., Schünemann, H.J., Togias, A., Akdis, M., Auffray, C., Bachert, C., Bieber, T., Bousquet, P.J., Carlsen, K.H., Casale, T.B., Cruz, A.A., Keil, T., Lodrup Carlsen, K.C., Maurer, M., Ohta, K., Papadopoulos, N.G., Roman Rodriguez, M., Samolinski, B., Agache, I., Andrianarisoa, A., Ang, C.S., Annesi-Maesano, I., Ballester, F., Baena-Cagnani, C.E., Basagaña, X., Bateman, E.D., Bel, E.H., Bedbrook, A., Beghé, B., Beji, M., Ben Kheder, A., Benet, M., Bennoor, K.S., Bergmann, K.C., Berrissoul, F., Bindslev Jensen, C., Bleecker, E.R., Bonini, S., Boner, A.L., Boulet, L.P., Brightling, C.E., Brozek, J.L., Bush, A., Busse, W.W., Camargos, P.A.M., Canonica, G.W., Carr, W., Cesario, A., Chen, Y.Z., Chiriac, A.M., Costa, D.J., Cox, L., Custovic, A., Dahl, R., Darsow, U., Didi, T., Dolen, W.K., Douagui, H., Dubakiene, R., El-Meziane, A., Fonseca, J.A., Fokkens, W.J., Fthenou, E., Gamkrelidze, A., Garcia-Aymerich, J., Van Wijk, R.G., Gimeno-Santos, E., Guerra, S., Haahtela, T., Haddad, H., Hellings, P.W., Hellquist-Dahl, B., Hohmann, C., Howarth, P., Hourihane, J.O., Humbert, M., Jacquemin, B., Just, J., Kalayci, O., Kaliner, M.A., Kauffmann, F., Kerkhof, M., Khayat, G., Koffi N'Goran, B., Kogevinas, M., Koppelman, G.H., Kowalski, M.L., Kull, I., Kuna, P., Larenas, D., Lavi, I., Le, L.T., Lieberman, P., Lipworth, B., Mahboub, B., Makela, M.J., Martin, F., Martinez, F.D., Marshall, G.D., Mazon, A., Melen, E., Meltzer, E.O., Mihaltan, F., Mohammad, Y., Mohammadi, A., Momas, I., Morais-Almeida, M., Mullol, J., Muraro, A., Naclerio, R., Nafti, S., Namazova-Baranova, L., Nawijn, M.C., Nyembue, T.D., Oddie, S., O'Hehir, R.E., Okamoto, Y., Orru, M.P., Ozdemir, C., Ouedraogo, G.S., Palkonen, S., Panzner, P., Passalacqua, G., Pawankar, R., Pigearias, B., Pin, I., Pinart, M., Pison, C., Popov, T.A., Porta, D., Postma, D.S., Price, D., Rabe, K.F., Ratomaharo, J., Reitamo, S., Rezagui, D., Ring, J., Roberts, R., Roca, J., Rogala, B., Romano, A., Rosado-Pinto, J., Ryan, D., Sanchez-Borges, M., Scadding, G.K., Sheikh, A., Simons, F.E.R., Siroux, V., Schmid-Grendelmeier, P.D., Smit, H.A., Sooronbaev, T., Stein, R.T., Sterk, P.J., Sunyer, J., Terreehorst, I., Toskala, E., Tremblay, Y., Valenta, R., Valeyre, D., Vandenplas, Olivier, Van Weel, C., Vassilaki, M., Varraso, R., Viegi, G., Wang, D.Y., Wickman, M., Williams, D., Wöhrl, S., Wright, J., Yorgancioglu, A., Yusuf, O M, Zar, H.J., Zernotti, M.E., Zidarn, M., Zhong, N., and Zuberbier, T.

Abstract

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies. Copyright © 2012 S. Karger AG, Basel.

Published
2012

44. Validity of instruments to measure physical activity may be questionable due to a lack of conceptual frameworks: a systematic review

Author

Gimeno-Santos, E, Frei, A, Dobbels, F, Rudell, K, Puhan, M A, Garcia-Aymerich, J, Gimeno-Santos, E, Frei, A, Dobbels, F, Rudell, K, Puhan, M A, and Garcia-Aymerich, J

Abstract

BACKGROUND: Regulators' guidance documents for the development and validation of patient reported outcomes (PROs) advise the use of conceptual frameworks, which outline the structure of the concept that a PRO aims to measure. It is unknown if currently available PROs are based on conceptual frameworks. This study, limited to a specific case, aimed (i) to identify conceptual frameworks of physical activity in chronic respiratory patients or similar populations (chronic heart disease patients or the elderly), and (ii) to assess if the development and validation of PROs to measure physical activity in these populations were based on a conceptual framework of physical activity. METHODS: Two systematic reviews were conducted through search in Medline, Embase, Psychinfo, and Cinahl databases up to January 2010. RESULTS: In the first review only 2 references, identified from 581 references about physical activity in the defined populations, provided a conceptual framework of physical activity in COPD patients. In the second review, out of 103 studies developing PROs to measure physical activity or related constructs, none of them was based on a conceptual framework of physical activity. CONCLUSIONS: These findings raise concerns about how the large body of evidence from studies that use physical activity PRO instruments should be evaluated by health care providers, guideline developers, and regulatory bodies.

Published
2011

46. Smartphone-Based Physical Activity Telecoaching in Chronic Obstructive Pulmonary Disease: Mixed-Methods Study on Patient Experiences and Lessons for Implementation

Author

Loeckx, Matthias, Rabinovich, Roberto A, Demeyer, Heleen, Louvaris, Zafeiris, Tanner, Rebecca, Rubio, Noah, Frei, Anja, De Jong, Corina, Gimeno-Santos, Elena, Rodrigues, Fernanda M, Buttery, Sara C, Hopkinson, Nicholas S, Büsching, Gilbert, Strassmann, Alexandra, Serra, Ignasi, Vogiatzis, Ioannis, Garcia-Aymerich, Judith, Polkey, Michael I, and Troosters, Thierry

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundTelecoaching approaches can enhance physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD). However, their effectiveness is likely to be influenced by intervention-specific characteristics. ObjectiveThis study aimed to assess the acceptability, actual usage, and feasibility of a complex PA telecoaching intervention from both patient and coach perspectives and link these to the effectiveness of the intervention. MethodsWe conducted a mixed-methods study based on the completers of the intervention group (N=159) included in an (effective) 12-week PA telecoaching intervention. This semiautomated telecoaching intervention consisted of a step counter and a smartphone app. Data from a project-tailored questionnaire (quantitative data) were combined with data from patient interviews and a coach focus group (qualitative data) to investigate patient and coach acceptability, actual usage, and feasibility of the intervention. The degree of actual usage of the smartphone and step counter was also derived from app data. Both actual usage and perception of feasibility were linked to objectively measured change in PA. ResultsThe intervention was well accepted and perceived as feasible by all coaches present in the focus group as well by patients, with 89.3% (142/159) of patients indicating that they enjoyed taking part. Only a minority of patients (8.2%; 13/159) reported that they found it difficult to use the smartphone. Actual usage of the step counter was excellent, with patients wearing it for a median (25th-75th percentiles) of 6.3 (5.8-6.8) days per week, which did not change over time (P=.98). The smartphone interface was used less frequently and actual usage of all daily tasks decreased significantly over time (P

Published
2018
Full Text
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47. An official European Respiratory Society statement on physical activity in COPD

Author

Watz, H, Pitta, F, Rochester, C L, Garcia-Aymerich, J, ZuWallack, R, Troosters, T, Vaes, A W, Puhan, Milo A, Jehn, M, Polkey, M I, Vogiatzis, I, Clini, E M, Toth, M, Gimeno-Santos, E, Waschki, B, Esteban, C, Hayot, M, Casaburi, R, Porszasz, J, McAuley, E, Singh, S J, Langer, D, Wouters, E F M, Magnussen, H, and Spruit, M A

Subjects
3. Good health

50. Cost-Effectiveness of a Prehabilitation Program in Patients Listed for Heart Transplantation.

Author

Castel, M.A., Lopez-Baamonde, M., Arguis, M.J., Burniol, A., Gimeno-Santos, E., Romano, B., Navarro-Ripoll, R., Torres, M. Farrero, Sanz-de la Garza, M., Sole, E., Sandoval, E., García-Alvárez, A., and Martinez-Palli, G.

Subjects
*HEART transplant recipients, *PREHABILITATION, *PRICE indexes, *COST analysis, *HEART failure patients, *AMBULATORY surgery
Abstract

Patients on the waiting list for Heart Transplantation (HT) benefit from prehabilitation programs to improve their physical condition prior to HT. However, the implementation of a prehabilitation program in advanced heart failure patients is health resource consuming and could represent an economical burden for HT centres. The aim of this study is to evaluate the cost-effectiveness of an ambulatory multimodal prehabilitation program for HT candidates. We performed a cost analysis of a prehabilitation program consisting of supervised exercise training, nutritional optimization and psychological support in patients undergoing elective HT in a single centre from 2017 to 2021. Healthcare use included cost of the prehab program and cost of the index hospitalization for HT measured by micro-costing techniques and hospital specific fees. Costs of the program included gym facilities, physiotherapist and nutritionist fees, protein supplementation and psychology fees. We compared total cost of patients attending the prehabilitation program (n=31) with a group of patients who did not join the program or were transplanted before the implementation of the program (n=51). To control for the skewness of the distribution a bootstrapping approach was performed. Mean cost of the prehabilitation program per patient was 2,195±1,336 €. Total mean cost per patient was lower in the prehab-group than in the control-group (56,503±24,169 vs. 66,556±33,593 €, p =0.12). The bootstrapping showed a difference in costs favouring the prehab-group of 2,248€ (95% CI: -10,952-15,010; p =0.37), although both differences were statistically non-significant. Main savings were driven by shorter ICU stay (5 vs. 7 d, p =0.01) and total LOS (18 vs. 23 d, p =0.008) and a reduction in pharmacy and blood costs. A multimodal prehabilitation program in patients awaiting HT could improve clinical outcomes without increasing costs. The cost of the program would be compensated by less postoperative complications. [ABSTRACT FROM AUTHOR]

Published
2023
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