• Tuberculosis and Respiratory Diseases
• /
• 제80권4호
• /
• pp.377-384
• /
• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• Tuberculosis and Respiratory Diseases
• /
• 제74권6호
• /
• pp.256-263
• /
• 2013

Background: Health status measure is not only important for clinical research studies but also for clinical practices of chronic obstructive pulmonary disease (COPD) patients. The objective of this study is to evaluate the validity of the Korean Version of COPD Assessment Test (CAT) in primary care clinics as well as in referral hospitals. Methods: Smokers or ex-smokers, aged 40 years or older, with a smoking history of >10 pack-years; and a COPD diagnosis in the past 6 months or more, were recruited from 4 primary care clinics and 2 referral hospitals. Demographic, medical, and spirometry data was collected from patients who completed the CAT and St. George Respiratory Questionnaire (SGRQ), and had their dyspnea been assessed. The primary endpoint was the correlation between of the Korean version of CAT with SGRQ in patients with COPD. Results: A total 100 patients were enrolled. The mean age and smoking amounts were $69.2{\pm}8.4$ years and $40.6{\pm}22.3$ pack-years, respectively. Sixty-seven percent of the patients reported at least one exacerbation in the past year. The mean CAT score was $16.9{\pm}8.0$. The internal consistency assessed by Cronbach's alpha was 0.85. The CAT score was positively correlated with the SGRQ score (r=0.76, p<0.0001) and each component of SGRQ: symptoms, activity and impacts; r=0.68, r=0.61, and r=0.72, respectively (all p<0.0001). These positive correlations were preserved in the different groups (r=0.86, p<0.0001 in primary care clinic group; r=0.69, p<0.0001 in hospital group). The CAT score was also positively correlated to the Medical Research Council dyspnoea scale (r=0.46, p<0.0001). Conclusion: The Korean version of CAT had good internal consistency and showed good correlations with SGRQ. It can be used for assessing the impacts of COPD on the patient's health including primary care setting.

• Physical Therapy Rehabilitation Science
• /
• 제10권1호
• /
• pp.40-47
• /
• 2021

Objective: The purpose of this study is to prove the reliability and validity of the Power breath K5 and to compare it with pony FX. Power breathe K5 is one type of device can assess automatically Maximum inspiratory pressure (MIP), Peak inspiratory pressure, Peak inspiratory flow (PIF). Design: Cross-sectional study. Methods: Thirty-five COPD patients participated in the test to investigate for the intra relater reliability and concurrent validity. The tests MIP, Vital capacity (VC), PIF were measured by Powerbreathe K5 and Pony Fx. Data was analyzed by intraclass correlation reliability (ICC) value and a standard error of measurement and Bland-Altman plots for reliability and pearson correlation for validity. Results: Intra rater reliability of the Powerbreathe K5 was very high at MIP (ICC=0.977 95%CI 0.956~0.989, SEM=8.665, MDC=0.295), PIF (ICC=0.966 95%CI 0.933~0.93, SEM=8.665, MDC=0.295), VC (ICC=0.949 95CI 0.902~0.974, SEM=0.042, MDC=0.116). The Powerbreath K5 was significant correlation compared with Pony Fx in assessment for MIP (r=0.971, p<0.05) and vital capacity (r=0.534, p<0.05). Conclusion: In this study, We investigated the clinical usefulness of the Powerbreath K5 in evaulating the MIP, VC and PIF with COPD patients with high reliability and validity.

• Tuberculosis and Respiratory Diseases
• /
• 제81권4호
• /
• pp.281-288
• /
• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• Tuberculosis and Respiratory Diseases
• /
• 제81권1호
• /
• pp.73-79
• /
• 2018

Background: Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS. Methods: This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted. Results: A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p<0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD. Conclusion: Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.

• 대한한의학회지
• /
• 제41권3호
• /
• pp.162-172
• /
• 2020

Objectives: The purpose of study was to report the clinical improvement of Chronic Obstructive Pulmonary Disease (COPD) patients treated with Korean medicine pulmonary rehabilitation. Methods: The patients were treated with Lung-conduction exercise, Chuna manual therapy, Exercise therapy. To assess the treatment outcomes, we used the pulmonary function test (PFT), modified medical research council scale (mMRC), 6-minute walk distance (6MWD), peak expiratory flow rate (PEFR), COPD assessment test (CAT), St. George respiratory questionnaire (SGRQ). Results: After treatments, the patient's clinical symptoms were improved with CAT, SGRQ's significant decrease and PFT, mMRC, 6MWD and PEFR were maintained or improved slightly. Conclusions: The Korean medicine pulmonary rehabilitation was effective in the treatment of COPD patients. This study suggested the possibility of Korean Medicine pulmonary rehabilitation program in the clinic.

• Tuberculosis and Respiratory Diseases
• /
• 제84권2호
• /
• pp.96-104
• /
• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• Tuberculosis and Respiratory Diseases
• /
• 제69권3호
• /
• pp.171-176
• /
• 2010

Background: The object of this study was to assess the validity and reliability of the Korean versions of chronic obstructive pulmonary disease assessment test (CAT) and Dyspnea-12 Questionnaire for patients with chronic pulmonary obstructive disease (COPD). Methods: For the 127 COPD patients, we obtained the Korean versions of the 3 questionnaires being tested: St George's Respiratory Questionnaire (SGRQ), CAT, and Dyspnea-12 with spirometric measurements. To assess the validity of CAT and Dyspnea-12, their correlation with SGRQ was evaluated. To assess the reliability of CAT and Dyspnea-12, Cronbach's alpha coefficient was evaluated. Results: The mean age of patient participants was $68.6{\pm}7.5$ years; 97.6% were male. The SGRQ score was correlated with the scores of the Korean version of CAT (r=0.71, p<0.0001) and Dyspnea-12 (r=0.73, p<0.0001). The Cronbach's alpha coefficient for the CAT and Dyspnea-12 were 0.77 and 0.78, respectively. Conclusion: The Korean versions of CAT and Dyspnea-12 were shown to be valid and reliable for the Korean COPD patients.

• Tuberculosis and Respiratory Diseases
• /
• 제87권1호
• /
• pp.65-79
• /
• 2024

Background: Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated. Methods: We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively. Results: Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George's Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV₁)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV₁ exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017). Conclusion: Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed.

• 한국콘텐츠학회논문지
• /
• 제17권11호
• /
• pp.410-422
• /
• 2017

본 연구의 목적은 만성 폐쇄성 폐질환자(COPD)의 질병관련 지식, 질병태도, 삶의 질 세요인간의 상관관계를 규명하고자 시도되었다. 연구결과 질병관련 지식은 대상자의 교육과 월수입, 주관적 호흡곤란 정도(mMRC), 흡입형 기관지 확장제, 항생제 치료에 따라 유의한 차이가 있었고 질병태도는 월수입, mMRC에 따라 유의한 차이가 있었다. 또한 삶의 질은 연령, 결혼상태, 월수입, 입원상태, 입원경험, 산소사용, 동반질환, mMRC, 흡입형 스테로이드에 따라 유의한 차이가 있었다. 질병관련 지식과 삶의 질(r=-.438, p<.001), 질병태도와 삶의 질(r=.279, p=.001)은 유의한 상관관계가 있는 것으로 나타났다. 따라서 세 요인에 공통적으로 상관성을 보인 변수인 월수입과 mMRC를 파악하는 것이 중요하며, 임상에서 COPD환자의 상태평가시, 객관적 검사결과 뿐만 아니라 mMRC의 사정에 관심을 가지고, 저소득계층을 중심으로 질병관련 지식향상과 긍정적인 태도함량을 위한 다학제간 접근과, 헬스코칭 프로그램을 개발하는 것이 필요하다.