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Background: Productive cough with sputum is a prominent sign generally associated with respiratory diseases, including chronic obstructive pulmonary disease (COPD). Airway clearance devices are an option for COPD management, but physicians’ preferences for and clinical practice with them are not known. Objective: This study aims to explore preferences for and clinical practice with airway clearance devices among physicians in Saudi Arabia. Design: An observational, cross-sectional survey. Methods: A self-administered questionnaire was conducted between October 2022 and September 2023, which included a review of respiratory medication prescriptions by physicians for patients with COPD. The analysis was performed using the Statistical Package for the Social Sciences. Results: The participants were 445 physicians. The majority were female, accounting for 64.3% of the sample. Flutter and Acapella were the most commonly preferred airway clearance devices (45.8% and 20.7%, respectively). Among the participants, 12.6% reported unfamiliarity with any of the mentioned devices. Of the participants, 43.6% “usually” suggested the devices for patients with daily, difficult-to-clear, thick sputum, while 27% “sometimes” recommended them to COPD patients who had experienced four exacerbations or more. In routine clinical practice, physicians prescribe pharmacological therapies as the main treatment. The prescribing data showed that in the last year, there was no record of prescribed airway clearance devices for COPD by physicians. Conclusion: Family and pulmonary physicians prefer Flutter and Acapella devices, but a significant number of physicians are unaware of such devices. Prescribing data showed no record of prescribed airway clearance devices for COPD management. Further initiatives are needed to increase awareness in clinical practice.

Background Nursing instructors play an important role in improving the clinical experience of nursing students. Despite this, little is known about the characteristics of effective clinical instructors. Objective Identifying the perceptions of nursing students, faculty, and preceptors of effective clinical instructors. Method A descriptive cross-sectional study was conducted using a convenience sample of nursing students, faculty, and preceptors from different nursing departments. Participants were invited to respond to sociodemographic and Nursing Clinical Teacher Effectiveness Inventory questionnaires from April 2022 to September 2022. The data were analyzed using descriptive and inferential statistics using SPSS. Result A total of 715 participants responded to the survey, of whom 510 were students. Students valued interpersonal relations (5.57 ± 1.261) as the most important clinical instructor characteristic, while nursing competence was perceived as the least important (5.51 ± 1.298). Faculty scored the highest mean in the evaluation subscale (6.21 ± 1.170) and the lowest in nursing competence (6.07 ± 1.221). Preceptors scored the highest mean in the evaluation subscale (5.98 ± 0.904) and the lowest in personality (5.80 ± 0.928). One-way ANOVA showed significant mean differences between the perceptions of nursing students, faculty, and preceptors in personality ( M : 5.54 vs. 6.10 vs. 5.80, respectively; p

Abstract Background Nonadherence to therapies and psychological disorders are associated with poor asthma control. This study aims to assess the prevalence of anxiety and depressive symptoms, asthma control, and adherence to inhalers and to investigate whether there is an association of anxiety and depressive symptoms with adherence to inhalers and asthma control. Methods We measured anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale in patients with asthma. Asthma Control Test and the 10-Item Test of Adherence to Inhalers Scale were used to assess levels of asthma control adherence to inhalers, respectively. Univariate and multivariate regression models assessed the associations of anxiety and depressive symptoms with adherence to inhalers and asthma control. Results A total of 287 patients completed the study, of whom 72% were female. The mean ± SD age and body mass index of our study population were 44 ± 13 years and 29 ± 7.2 kg/m2, respectively. Poor adherence to inhaler use was highly prevalent (49.8%; 95% CI: 43.8 to 55.7). The prevalence of anxiety, depression and poor asthma control was 27.2% (95% CI: 22.1 to 32.7), 20.9% (95% CI: 16.3 to 26.1), and 22.7% (95% CI: 17.9 to 27.9), respectively. We found a negative relationship between asthma control and anxiety, and depressive symptoms (adjusted β: -0.25; 95% CI: -0.36 to -0.14; p

Background: Night shift duties are crucial in the ICU to ensure care continuity, where critically ill patients require round-the-clock care. However, cumulative night shift duties may disturb circadian rhythm, insomnia, fatigue, and depression, and require further elucidation. Objectives: This study aims to examine the negative consequences of various night shift patterns on insomnia, fatigue, and mental health of ICU Workers. Methods: A cross-sectional study examined how cumulative night shift duty affects insomnia, fatigue, and mental health in critical care providers (CCPs). Results: A total of 1006 participants completed this study between June 2022 and March 2023, including 54.5 % males. About 35 % were between 20 and 30 years of age, and Respiratory Therapists accounted for approximately 46.5 % of the entire sample. Most of our respondents (476; 47 %) reported working night shifts, with a monthly range of 8–15 nights. The prevalence rates for moderate to severe clinical insomnia, fatigue, and moderate to severe depression were 42 %, 48 %, and 32 %, respectively. CCPs working 8–15 nights had a 2-fold risk of clinical insomnia than those working fewer than eight nights with (AOR) and 95 % (CI) of 2.12 and 1.41–3.20, while those working ≥16 nights per month had a greater incidence of clinical insomnia compared to those working

Background and Objectives: Asthma is associated with several comorbidities, one of which is obesity. The worldwide increase in obesity has been accompanied by a parallel rise in asthma prevalence, with obesity recognized as a significant risk factor for both the development and severity of asthma. Obesity is often linked to various comorbidities, which can complicate asthma management and lead to poorer clinical outcomes. This study aims to investigate the prevalence of obesity and its comorbidities in adults with asthma in a single center in Saudi Arabia, providing an overview of the associated health implications. Materials and Methods: This single-center, retrospective study aimed to assess the prevalence of obesity and other comorbidities in asthma patients. Data were collected from King Khalid University Hospital in Saudi Arabia between July 2023 and December 2023. Results: This study revealed that 72.1% of asthma patients were either obese or overweight. Female patients had significantly higher BMI values compared to males. Our study revealed that 38.21% of female asthma patients (mean age = 57 ± 13.85 years) had comorbidities compared to 24.14% of male asthma patients (mean age = 59 ± 14.02 years). Furthermore, the proportion of obese asthmatic patients with comorbidities was significantly greater than those without comorbidities. Conclusions: This study investigates obesity prevalence and associated comorbidities in adult asthmatics in a single center in Saudi Arabia. The findings reveal a 72.1% rate of obesity and overweight among asthmatic patients, with higher BMI and comorbidity prevalence in females. These results underscore the need for targeted interventions addressing obesity and comorbidities, especially in female asthmatics.

BackgroundTobacco smoking is one of the most significant health-related problems worldwide. However, the prevalence and sociodemographic determinants of tobacco and nicotine use among students on healthcare courses in Saudi Arabia are limited.MethodsThis cross-sectional study used a questionnaire that was distributed via SurveyMonkey between November 2022 and June 2023 to all student universities offering healthcare courses. Data are presented as frequency and percentages. The associated sociodemographic factors with current tobacco and nicotine use were subjected to logistic regression.ResultsOverall, 5,012, of whom 3,872 (77.25%) were males, responded to the online survey. The prevalence of current tobacco and nicotine use was 3,553 (71%). The majority of users used electronic nicotine delivery systems (1,622: 32.36%). The current use of cigarettes (AOR: 1.75 (1.42 to 2.15)), e-cigarettes (AOR: 1.17 (1.01 to 1.37)), and smokeless tobacco substances (AOR: 1.35 (1.02 to 1.90)) were more pronounced among males compared to female students. However, the current use of a hookah was less among males (AOR: 0.74 (95% CI: 61 to 0.91)). Smoking cigarettes was practiced less among students living in other regions compared to the Central Region. However, smokeless tobacco substances seem to be more prevalent in the Western, Southern, and Northern Regions, (AOR: 1.57 (95% CI: 1.09 to 2.26)), (AOR: 1.43 (95% CI: 1.04 to 1.95)), and (AOR: 1.57 (95% CI: 1.09 to 2.26)), respectively.ConclusionSmoking is prevalent among students in the healthcare disciplines, with electronic nicotine delivery systems being the most used product. Several sociodemographic factors were associated with higher tobacco or nicotine use.

Background: Obesity is a common cause of dyspnea. However, the impacts of obesity on spirometry parameters, particularly among individuals with unexplained dyspnea, have not been well investigated. Objectives: This study aimed to explore the prevalence of overweight and different classes of obesity and their effect on spirometry parameters among subjects with unexplained dyspnea in Saudi Arabia. Methods: We conducted a retrospective electronic medical record review of individuals with unexplained dyspnea who visited our pulmonary clinic between January 2016 and December 2022 and assessed the association of body mass index (BMI) with spirometry parameters. After we classified the subjects based on their BMI values, we determined the impacts of increased BMI on spirometry parameters. Results: The sample included a total of 978 subjects with unexplained dyspnea. The prevalence of overweight and obesity among our study sample was high (33 % and 47 %, respectively). All spirometry parameters: forced vital capacity (FVC) L, forced expiratory volume in 1 s (FEV1) L, forced expiratory flow at 25–75 % (FEF 25–75 %) L/sec and peak expiratory flow (PEF) L/sec were significantly lower in obese individuals with dyspnea compared to normal weight subjects. In addition, our findings showed a negative correlation between BMI and FVC, FEV1, FEF 25–75 %, and PEF. Conclusion: The high prevalence of obesity and overweight and the impairment of lung function because of high body weight among subjects with dyspnea point to the need for routine assessment and the evaluation of nutritional status in primary health care facilities for early intervention.

BackgroundLung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases.MethodA cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer.ResultsMajority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p < 0.001).ConclusionPublic awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms.

Background: Limited data is available on awareness and clinical management of the airway pressure release ventilation (APRV) mode of ventilation for acute respiratory distress syndrome (ARDS) patients among physicians who work at in adult critical areas. This study aimed to assess the knowledge and current practice of using APRV mode with ARDS patients and identify barriers to not using this mode of ventilation among physicians who work in adult critical areas in Saudi Arabia. Methods: Between November 2022 and April 2023, a cross-sectional online survey was disseminated to physicians who work in adult critical areas in Saudi Arabia. The characteristics of the respondents were analyzed using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 498 physicians responded to the online survey. All responders (498, 100 %) reported that APRV is indicated in patients with ARDS, but 260 (52.2 %) did not know if there was an institutionally approved APRV protocol. Prone positioning was the highest recommended intervention by 164 (33.0 %) when a conventional MV failed to improve oxygenation in patients with ARDS. 136 (27.3 %) responders stated that the P-high should be set equal to the plateau pressure on a conventional ventilator while 198 (39.8 %) said that P-low should be 0 cmH2O. Almost half of (229, 46.0 %) responders stated that the T-high should be set between 4 and 6 s, while 286 (57.4 %) said that the T-low should be set at 0.4–0.8 s. The maximum allowed tidal volume during the release phase should be 4–6 ml/kg. Moreover, just over half (257, 51.6 %) believed that the maximum allowed P-high setting should be 35 cmH2O. One third of the responders (171, 34.3 %) stated that when weaning patients with ARDS while in APRV mode, the P-high should be reduced gradually to reach a target of 10 cmH2O. However, 284 (36.9 %) thought that the T-high should be gradually increased to reach a target of 10 s. Most responders (331, 66.5 %) felt that the criteria to switch the patient to CPAP would be to have an FiO2 ≤ 0.4, P-high ≤10 cm H2O, and T-high ≥10 s. Lack of training has been the most common barrier to not using APRV by 388 (77.9 %). Conclusion: There is a lack of consensus on the use of APRV mode, probably due to several barriers. While there were some agreements on the management of ventilation and oxygenation, there were variations in the selection of the initial setting of APRV. Education, training, and the presence of standardized protocols may help to provide better management.

Pulmonary hypertension (PH) due to chronic obstructive pulmonary disease (COPD) is classified as Group 3 PH, with no current proven targeted therapies. Studies suggest that cigarette smoke, the most risk factor for COPD can cause vascular remodelling and eventually PH as a result of dysfunction and proliferation of pulmonary artery smooth muscle cells (PASMCs) and pulmonary artery endothelial cells (PAECs). In addition, hypoxia is a known driver of pulmonary vascular remodelling in COPD, and it is also thought that the presence of hypoxia in patients with COPD may further exaggerate cigarette smoke-induced vascular remodelling; however, the underlying cause is not fully understood. Three main pathways (prostanoids, nitric oxide and endothelin) are currently used as a therapeutic target for the treatment of patients with different groups of PH. However, drugs targeting these three pathways are not approved for patients with COPD-associated PH due to lack of evidence. Thus, this review aims to shed light on the role of impaired prostanoids, nitric oxide and endothelin pathways in cigarette smoke- and hypoxia-induced pulmonary vascular remodelling and also discusses the potential of using these pathways as therapeutic target for patients with PH secondary to COPD.

Background The issue of burnout syndrome among health discipline students is gaining heightened attention due to its serious effects, which causes them to have the intention to quit. Despite this, limited studies are available on the extent of burnout and its association with resilience and intention to drop out among clinical-level nursing students. Objective To explore the relationship between burnout, resilience, and intention to quit among nursing students. Methods An online questionnaire was used to conduct a cross-sectional study, targeting nursing students at the clinical level through a nonprobability sample. The participants were required to provide their sociodemographic, Maslach Burnout Inventory, and Connor-Davidson Resilience Scale. Data was analyzed using descriptive, inferential, and correlation tests. Results The study included a group of 564 nursing students and interns, the majority of whom were female at a percentage of 78.9%. Among this group, 65% experienced a high level of burnout, with 42% experiencing emotional exhaustion, 54% experiencing depersonalization (DP), and 77% reporting low personal achievement. A total of 48% of clinical-level students were considering quitting the nursing program. Moreover, the students reported low scores of resilience, with negative correlations observed with DP ( r = −.12, p = .04) and positive correlation with low personal achievement ( r = .43, p

BackgroundPulmonary hypertension due to chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) is classified as group 3 pulmonary hypertension. Inhaled treprostinil, a prostaglandin I2 analogue also known as prostacyclin, has recently been approved as a first drug for patients with pulmonary hypertension secondary to ILD. However, due to a lack of evidence, no therapies are currently approved for those with COPD-associated pulmonary hypertension. Thus, this systematic review aims to summarise the current evidence to assess the impact of inhaled prostaglandin I2 analogue use on the pulmonary hemodynamics, exercise function, lung function, and gas exchange in patients with pulmonary hypertension due to COPD.MethodsWe systematically searched the electronic databases of Medline, Embase, Scopus and Cochrane from inception to 1 February 2023. Studies of adult patients with a confirmed diagnosis of COPD-associated pulmonary hypertension who received inhaled drugs targeting the prostacyclin pathway were included in the systematic review. Case reports, systematic reviews, conference abstracts with no full text, non-full-text articles, non-English manuscripts and book chapters were excluded from this systematic review. A risk-of-bias assessment was carried out for the studies included in this review, using two different Cochrane risk-of-bias tools for randomised and non-randomised clinical trials.ResultsA total of four studies met our inclusion criteria and were included in this systematic review. The results of one prospective clinical trial showed an improvement in the pulmonary hemodynamics (e.g., cardiac index, cardiac output and mean pulmonary artery pressure) in response to inhaled prostacyclin use in patients with pulmonary hypertension secondary to COPD. However, the severity of dyspnoea, lung function, exercise capacity and gas exchange were not affected when inhaled prostacyclin was used for patients with COPD-related pulmonary hypertension.ConclusionThis systematic review demonstrated that although inhaled prostacyclin does not seem to improve COPD-related outcomes (e.g., lung function and exercise capacity), short-term use of inhaled prostacyclin has the potential to reduce mean pulmonary artery pressure and pulmonary vascular resistance without impairing ventilation-perfusion mismatch. Further studies with larger sample sizes are warranted.Systematic review registrationCRD42022372803, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=372803.

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35–1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48–0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61–2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students’ engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes.

Cognitive impairment is a common comorbidity in patients with COPD, significantly impacting health and clinical outcomes. Yet it remains under investigated and is largely overlooked. Although the exact cause of cognitive impairment in patients with COPD is still unclear, factors such as hypoxemia, vascular disease, smoking, exacerbation, and physical inactivity have been suggested. While international guidelines recommend identifying comorbidity in patients with COPD, such as cognitive impairment, cognitive assessment is not yet part of the routine assessment. Unidentified cognitive deficits in patients with COPD may have severe impacts on clinical management, resulting in an inability to maintain functional independence, poor self-management, and a greater dropout from pulmonary rehabilitation programs. There is a need to consider cognitive screening as a part of COPD assessment to promote early detection of cognitive impairment. Recognizing cognitive impairment early in the course of the illness allows the development of individualized interventions to meet patients’ needs and improve clinical outcomes. Pulmonary rehabilitation should be tailored to cognitively impaired patients with COPD to maximize the benefits and minimize the incompletion rate.

Background and Objectives: In both pandemic and non-pandemic situations, nonpharmaceutical public health measures may offer easy, low-cost, and effective means of reducing the spread and impact of acute respiratory infections. It is unknown whether such measures would be acceptable to the Saudi community beyond the current pandemic. Materials and Methods: A validated survey was used to test community acceptance of the measures. Respondents were asked which infection control practices they planned to maintain and which they believed should be policies for the community as a whole after the COVID-19 pandemic has subsided. Results: The survey was completed by 2057 people (95% completion rate), 1486 (72%) of whom were female, 259 (12.5%) of whom were current smokers, and 72 (3.5%) of whom had chronic lung disease. The most prevalent age groups were 18–30 years (933; 45.4%) and 31–40 years (483; 23.5%), with 641 individuals over 40 years old. Of the responses, 93% indicated that they would continue washing their hands more often; 92% wanted both clinicians and patients to wear masks in hospitals; 86% would continue avoiding smoking in indoor and outdoor areas; 73% would continue wearing a face covering on public transportation; 70% indicated that they would continue wearing a face covering in indoor public places. Regarding the respiratory virus infection control measures, 85% (11/13) received significant support (≥70% acceptability level) for continuation as policies in the future. Wearing face coverings outdoors and social distancing outdoors received little support (45% and 66%, respectively). Of the respiratory virus infection control measures, 54% received less support from current smokers than non-smokers (acceptability level < 70%). People with chronic respiratory disease supported 77% of the measures being regarded as policies in the future. Conclusion: The Saudi community supports nonpharmacological respiratory infection control measures that reduce the likelihood of infection. Public health campaigns should target smokers to increase awareness of the importance of these measures in lowering infections. Based on the findings of this study, nonpharmacological treatments should be presented and included in future recommendations for both the public and patients diagnosed with chronic respiratory diseases.

Objectives The objective of this study is to examine the hospitalisation profile for respiratory diseases in Australia between 1998 and 2019.Design An ecological study.Setting A population study that involved all private and public hospitalisations for respiratory diseases in Australia from 1998 to 2019. Data were gathered from the National Hospital Morbidity Database.Participants All patients who were hospitalised at all private and public hospitalisations for respiratory diseases in Australia.Primary outcome measure Hospitalisation rates related to respiratory diseases.Results A total of 8 090 021 hospital admission episodes for diseases of the respiratory system were recorded in Australia between 1998 and 2019. Hospital admission rates increased by 12.4%, from 1766.45 (95% CI 1760.50 to 1772.41) in 1998 to 1985.86 (95% CI 1980.43 to 1991.28) in 2019 per 100 000 persons, p

Introduction: Imposter syndrome is common among health disciplinary students, leading to serious consequences. However, the impact of imposter syndrome on self-esteem and quitting intention among respiratory therapy students has not been well researched. Objective: To report on the prevalence of imposter syndrome and assess its impacts on self-esteem and quitting intention among respiratory therapy students in Saudi Arabia. Methods: A nonprobability cross-sectional questionnaire using the Clance Impostor Phenomenon Scale and the Rosenberg Self-Esteem Scale was self-administered and distributed among respiratory therapy students between October 2022 and April 2023. Data analysis was performed using Descriptive and inferential statistics. Results: Of the 1500 respiratory therapy students invited to participate in the study, 901 surveys were completed; and thus, included in the final analysis. Of whom, 92% were presented with imposter syndrome: 44% with moderate, 35% with frequent, and 13% with intense feelings. In addition, 60% of respiratory therapy students and interns experienced low self-esteem, while only 0.5% indicated high self-esteem. More than 50% of the study participants thought about quitting the respiratory therapy program, and 30% have been diagnosed with psychological disorders. Furthermore, there was a significant association between imposter syndrome and low self-esteem, p 0.005). Conclusion: Imposter syndrome and low self-esteem are prevalent among respiratory therapy students, both of which are associated with considering leaving the respiratory therapy program. Effective interventions should be implemented to ameliorate the symptoms imposter syndrome and low self-esteem; thus, improving the academic experience of respiratory therapy students.

Abstract Background With the advances in neonatal intensive care, the survival rate of extremely preterm infants is increasing. However, bronchopulmonary dysplasia (BPD) remains a major cause of morbidity among infants in this group. This study examined the changes in respiratory support modalities, specifically heated humidified high-flow nasal cannula (HHHFNC), and their association with BPD incidence among preterm infants born at

Objectives Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known.Design A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients.Setting Saudi Arabia.Participants 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists.Primary outcome measures Healthcare providers’ level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia.Results 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them.Conclusion Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients.

Objective To investigate physicians’ perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD).Design A cross-sectional online survey was employed between March and September 2022.Settings Saudi Arabia.Participants 1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists.Primary outcome measures Physicians’ perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD.Results A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients’ feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p

BackgroundThere is a concerning lack of representative data on chronic obstructive pulmonary disease (COPD) awareness in Saudi Arabia, and a significant proportion of the population is vulnerable to developing a smoking habit, which is a major risk factor for the disease.MethodsPopulation-Based Survey of 15,000 people was conducted to assess the public knowledge and awareness of COPD across Saudi Arabia from October 2022 to March 2023.ResultsA total of 15002 responders completed the survey, with a completion rate of 82%. The majority 10314 (69%) were 18-30 year and 6112 (41%) had high school education. The most common comorbidities among the responders were depression (7.67%); hypertension (6%); diabetes (5.77%) and Chronic Lung Disease (4.12%). The most common symptoms were dyspnea (17.80%); chest tightness (14.09%) and sputum (11.19%). Among those who complains of any symptoms, only 16.44% had consulted their doctor. Around 14.16% were diagnosed with a respiratory disease and only 15.56% had performed pulmonary function test (PFT). The prevalence of smoking history was 15.16%, in which current smokers were 9.09%. About 48% of smokers used cigarette, 25% used waterpipe and around 27% were E-cigarette users. About 77% of the total sample have never heard about COPD. Majority of current smokers (73.5%; 1002), ex-smokers (68%; 619), and non-smokers (77.9%; 9911) are unaware of COPD, p value ConclusionThere is a significantly low awareness about COPD in Saudi Arabia, especially among smokers. A nationwide approach must include targeted public awareness campaigns, continued healthcare professional education, community-based activities encouraging diagnosis and early detection, advice on smoking cessation and lifestyle changes, as well as coordinated national COPD screening programs.