دورية أكاديمية
أعرض في EDS

A Multi-Specialty Delphi Consensus on Assessing and Managing Cardiopulmonary Risk in Patients with COPD.

التفاصيل البيبلوغرافية
العنوان: A Multi-Specialty Delphi Consensus on Assessing and Managing Cardiopulmonary Risk in Patients with COPD.
المؤلفون: Bhutani M; Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada., Bourbeau J; Department of Medicine, Division of Pulmonary Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada., Goodman SG; Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada., Hawkins NM; Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia., Kaplan AG; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada., Lin PJ; The Canadian Heart Research Centre, Primary Care Initiatives, Toronto, Ontario, Canada., Penz ED; College of Medicine, Division of Respirology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Verma S; Department of Surgery, Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada., Zieroth S; College of Medicine, Section of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada.
المصدر: International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2024 Sep 19; Vol. 19, pp. 2051-2062. Date of Electronic Publication: 2024 Sep 19 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: DOVE Medical Press Country of Publication: New Zealand NLM ID: 101273481 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2005 (Electronic) Linking ISSN: 11769106 NLM ISO Abbreviation: Int J Chron Obstruct Pulmon Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Auckland, N.Z. : DOVE Medical Press,
مواضيع طبية MeSH: Pulmonary Disease, Chronic Obstructive*/diagnosis , Pulmonary Disease, Chronic Obstructive*/therapy , Pulmonary Disease, Chronic Obstructive*/epidemiology , Pulmonary Disease, Chronic Obstructive*/physiopathology , Delphi Technique* , Consensus* , Cardiovascular Diseases*/prevention & control , Cardiovascular Diseases*/epidemiology , Cardiovascular Diseases*/diagnosis , Cardiovascular Diseases*/therapy, Humans ; Risk Assessment ; Canada/epidemiology ; Cardiologists/standards ; Heart Disease Risk Factors ; Lung/physiopathology ; Pulmonary Medicine/standards ; Comorbidity ; Patient Care Team/standards ; Pulmonologists ; Interdisciplinary Communication ; Risk Factors ; Cooperative Behavior ; Prognosis ; Predictive Value of Tests
مستخلص: Background: In Canada, COPD represents a significant burden to the patient and health system, as it is often under or misdiagnosed and sub-optimally treated. Cardiovascular disease (CVD) is a common co-morbidity in COPD and there is significant interplay between these two chronic conditions. Across all stages of COPD disease severity, deaths can be attributed not only to respiratory causes but also to cardiovascular-related factors. The established links between COPD and CVD suggest the need for a greater degree of collaboration between respirologists and cardiologists. This modified Delphi consensus was initiated to consider how optimal COPD care can be delivered within Canada, with specific consideration of reducing cardiopulmonary risk and outcomes in COPD patients.
Methods: A steering group with interest in the management of COPD and CVD from primary care, cardiology, and respirology identified 40 statements formed from four key themes. A 4-point Likert scale questionnaire was sent to healthcare professionals working in COPD across Canada by an independent third party to assess agreement (consensus) with these statements. Consensus was defined as high if ≥75% and very high if ≥90% of respondents agreed with a statement.
Results: A total of 100 responses were received from respirologists (n=30), cardiologists (n=30), and primary care physicians (n=40). Consensus was very strong (≥90%) in 28 (70%) statements, strong (≥75 and <90%) in 7 (17.5%) statements and was not achieved (<75%) in 5 (12.5%) of statements.
Conclusion: Based on the consensus scores, 9 key recommendations were proposed by the steering group. These focus on the need to comprehensively risk stratify and manage COPD patients to help prevent exacerbations. Consensus within this study provides a call to action for the expeditious implementation of the latest COPD guidelines from the Canadian Thoracic Society.
Competing Interests: No authors received honoraria from AstraZeneca for this project. Previous honoraria received by the authors includes: M Bhutani reports grants, contracts, consulting fees, support for travel, or honoraria from CIHR, AstraZeneca, GlaxoSmithKline, Novartis, Grifols, Sanofi, Takeda, Covis, Valeo, Lung Association of Saskatchewan, Canadian Thoracic Society, Lung Association of Alberta and Northwest Territories; leadership roles with Canadian Thoracic Society and Alberta Health Services; Canadian Thoracic Society Executive Committee, Co-Chair of the CTS COPD Clinical Assembly; Chair of the Royal College of Physicians and Surgeons Adult Respiratory Examination. J Bourbeau reports grants from McGill University, the McGill University Health Centre Foundation, the Canadian Institute Health Research, Grifols, Novartis, Sanofi, and the Respiratory Health Network of the Fonds de la recherche en santé du Québec; grants and personal fees (honoraria) from Astra Zeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, and Trudell Canada Ltd; and personal fees (honoraria) from Pfizer Canada Ltd, and COVIS Pharma Canada Ltd, outside the submitted work. SG Goodman reports research grant support (eg, steering committee or data and safety monitoring committee) and/or speaker/consulting honoraria (eg, advisory boards) from: Amgen, Alnylam, Anthos Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, CYTE Ltd., Daiichi-Sankyo/American Regent, Eli Lilly, Esperion, Ferring Pharmaceuticals, HLS Therapeutics, Idorsia, JAMP Pharma, Merck, Novartis, Novo Nordisk A/C, Pendopharm/Pharmascience, Pfizer, Regeneron, Roche, Sanofi, Servier, Tolmar Pharmaceuticals, Valeo Pharma; and salary support/honoraria from the Canadian Heart Failure Society, Canadian Heart Research Centre and MD Primer, Canadian VIGOUR Centre, Cleveland Clinic Coordinating Centre for Clinical Research, Duke Clinical Research Institute, Jewish General Hospital\ CIUSSS Centre-Ouest-de-l’Ile-de-Montreal, Peter Munk Cardiac Centre Clinical Trials and Translation Unit, Ted Rogers Centre for Heart Research, New York University Clinical Coordinating Centre, PERFUSE Research Institute, TIMI Study Group (Brigham Health). NM Hawkins reports research grant support, served on advisory boards for, or speaker engagements with AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Servier. AG Kaplan reports consulting fees or honoraria from AstraZeneca, ALK, Bellus, BI, Covis, Cipla, Eisai, GSK, Merck Frosst, Metapharm, Moderna, Novo Nordisk, Pfizer Sanofi, Teva, Trudell, Valeo; Chairperson of Family Physician Airways Group of Canada; Vice president of Respiratory Effectiveness Group. AGK is an honorary professor of primary care Respiratory Research, Observational and Pragmatic Research Institute; Medical director, local pulmonary rehabilitation program; Board member, Thrombosis Canada; Senate member of the International Primary Care Respiratory Group. P Lin reports speaker honorarium for CME events from AstraZeneca, GlaxoSmithKline, Medexus, Moderna, Pfizer, Amgen, Novo Nordisk, Boehringer-Ingelheim, and Eli Lilly. ED Penz reports consulting fees, support for travel, or honoraria from AstraZeneca, GlaxoSmithKline, Sanofi, Covis, LungSask, Canadian Thoracic Society, Valeo; research funds from CIHR, Saskatchewan Health Research Foundation, Respiratory Research Center, LungSask, Saskatchewan Centre for Patient oriented research, and AstraZeneca. She reports contract with Saskatchewan Cancer Agency for her role as medical advisor for the Saskatchewan Lung Screening program, board member of Institute of Cancer Research Advisory Board (CIHR), Canadian Thoracic Society Executive Committee, and Past Co-Chair of the CTS COPD Clinical Assembly. S Verma holds a Tier 1 Canada Research Chair in Cardiovascular Surgery, and reports receiving research grants and/or speaking honoraria from Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Canadian Medical and Surgical Knowledge Translation Research Group, Eli Lilly, HLS Therapeutics, Janssen, Novartis, Novo Nordisk, Pfizer, PhaseBio, S & L Solutions Event Management Inc, and Sanofi. He is the President of the Canadian Medical and Surgical Knowledge Translation Research Group, a federally incorporated not-for-profit physician organization. S Zieroth reports research grant support, served on advisory boards for, or speaker engagements with AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Cytokinetics, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Servier and Vifor Pharma; and serves on a clinical trial committee or as a national lead for studies sponsored by AstraZeneca, Bayer, Boehringer Ingelheim, Merck, Novartis, and Pfizer. The authors report no other conflicts of interest in this work.
(© 2024 Bhutani et al.)
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فهرسة مساهمة: Keywords: Canada; chronic obstructive pulmonary disease; consensus development; consultation and referral; health care; primary care
تواريخ الأحداث: Date Created: 20240925 Date Completed: 20240925 Latest Revision: 20240926
رمز التحديث: 20240926
مُعرف محوري في PubMed: PMC11420896
DOI: 10.2147/COPD.S471952
PMID: 39318837
قاعدة البيانات: MEDLINE
الوصف
تدمد:1178-2005
DOI:10.2147/COPD.S471952