Top 5 Most-Read COPD Stories of 2020

The top 5 most-read stories on chronic obstructive pulmonary disease (COPD) of 2020 on AJMC.com heavily on study findings on how health care providers can improve care for patients with COPD.

The effects of high-flow nasal cannula (HFNC) in relation to more conventional oxygen therapies was the focus of 2 of our 5 stories, with both showing better patient outcomes when using HFNC. Another study showed that many patients with COPD do not use their inhalers properly.

Lastly, a look at COPD risk factors revealed to researchers that may experience differences in symptom severity depending on which risk factors they are exposed to across their lifetime.

5. HFNC May Improve AECOPD Prognosis Better Than Conventional Therapy

HFNC may be a better option for first-line oxygen therapy for patients with COPD with acute compensated hypercapnic respiratory failure than conventional therapy options, according to a study published in November. The trial looked at 320 hospitalized patients and found that the primary endpoint of treatment failure occurred significantly less for patients receiving HFNC than conventional oxygen therapy, occurring in 10% of patients in the HFNC group compared with 19.4% patients in the conventional oxygen group. Investigators suggested that in addition to optimized COPD therapy, oxygenation devices should be used on select patients to achieve the best possible outcomes.

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4. Study Finds Variation in COPD Characteristics by Risk Factors

Patients with COPD exposed to certain risk factors, including tobacco exposure, biomass smoke, and occupational exposure may experience a difference in disease severity. Although results showed that those exposed to tobacco smoke in combination with other risk factors had more severe COPD symptoms than other groups, patients in the tobacco alone group had less severe symptoms and lower exacerbation ratios than patients predominately exposed to biomass smoke or occupational exposure. Investigators said that their findings suggested that tobacco exposure in addition to other risk factors can have a noxious additive effect in patients with COPD.

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3. Study Finds High Rate of Errors in Inhaler Technique and Treatment Nonadherence for COPD

A study of hospitalized patients with COPD and asthma found that more than a quarter of them do not use proper inhaler technique and struggle with treatment adherence. The results showed that 26.1% of patients has 1 or more critical errors when using an inhaler, with the 2 most common critical errors referring to inhaler charging and positioning as well as inhaling/breathing errors. Additionally, 30.4% of patients self-reported that they had issues being adherent with drug medication. Investigators said that the results showed that interventions to improve inhaler technique and adherence to medications are needed going forward.

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2. Treatment Failure Less Likely With HFNC Than NIV Among Patients With COPD, Study Finds

Compared with non-invasive ventilation (NIV), HFNC oxygen therapy carried less risk of treatment failure among patients, according to a study looking at the outcomes of these 2 therapies in 86 patients. In addition to experiencing lower treatment failure risks, patients were more comfortable, had significantly less airway care interventions, and has less cases of nasofacial skin breakdown when treated with HFNC. Until this study, there had been little evidence on whether HFNC is a viable option for COPD patients with hypercapnic respiratory failure after intubation.

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1. Periods of Acute Exercise Do Not Significantly Alter Concentrations of Inflammatory Mediators in COPD

In a study assessing the effect of exercise in pulmonary rehabilitation in patients with COPD,researchers observed that short periods of acute exercise did not significantly alter circulating concentrations of fibrinogen and C-reactive protein. They also found that a short period of exercise can increase white blood cell subsets post-exercise and patients experienced rises in leukocyte and neutrophil counts. Investigators said the results implied that acute exercise used within pulmonary rehabilitation may not be sufficient at inducing an inflammatory response of fibrinogen and may need to be more strenuous and/or prolonged.

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