Article

Diagnosis and treatment considerations for women with COPD

Division of Pulmonary-Critical Care Medicine, The Bay Pines Veterans Affairs Healthcare System, University of South Florida, Tampa, FL 33744, USA.
International Journal of Clinical Practice (Impact Factor: 2.54). 04/2009; 63(3):486-93. DOI: 10.1111/j.1742-1241.2008.01987.x
Source: PubMed

ABSTRACT The worldwide prevalence of chronic obstructive pulmonary disease (COPD) is growing faster in women than in men. Over the past two decades, COPD-related mortality rates have also grown faster in women, and since the year 2000 more women than men have died from COPD. The greater prevalence of COPD and related mortality reported for men in earlier epidemiological studies may be due to under-diagnosis of women. In addition, factors such as prevalence of symptoms, triggering stimuli, response to treatment, susceptibility to smoking, frequency of exacerbations, impairment in quality of life response to oxygen therapy, presence of malnutrition, airway hyper-responsiveness and depression are more frequently seen in women with COPD. Despite these differences, the current guidelines for the diagnosis and treatment of men or women with COPD are the same. It is important for healthcare professionals to recognise the gender differences in patients with COPD to optimise assessment, monitoring and treatment of this disease. This article reviews the clinical differences between men and women with COPD, current treatment guidelines and its implications for improvement in the management of women with COPD.

0 Bookmarks
 · 
82 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although there is substantial evidence to support the importance of pulmonary rehabilitation (PR) in the management of chronic obstructive pulmonary disease, there is less evidence for gender-associated differences in the response to PR. The purpose of this review was to systematically identify and synthesize the available literature on whether men and women with chronic obstructive pulmonary disease respond differently to PR. A search of 4 electronic databases was conducted (January 1990 to May 2012) for all English language articles where the goal was to assess gender differences in outcomes after PR. Of the 116 articles retrieved, 11 were included. Five studies reported differences between men and women after PR, for the outcomes of dyspnea, health-related quality of life, physical capacity, psychological and functional status, and coping strategies. Six studies reported no difference in response to PR for the same outcomes. No differences in study designs, study quality, participant characteristics, and type and duration of PR programs were observed between studies that showed gender differences and those that did not. There was insufficient evidence to support or refute gender-associated differences in PR outcomes. The impact of gender on the outcome of PR and how these differences may affect the delivery of PR programs remains to be defined.
    Journal of cardiopulmonary rehabilitation and prevention 11/2013; DOI:10.1097/HCR.0000000000000018 · 1.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac rehabilitation (CR) outcomes are measured in terms of cardiovascular disease (CVD) risk factor reductions, and these predict long-term cardiac status. This report examines whether reported tobacco use has differential effects on successful cardiovascular risk factor modification, especially for women who have greater smoking-related CVD consequences than men. A retrospective cohort analysis was conducted on 1138 adults (74% male) with diagnosed CVD who participated in ≥7 weeks of a comprehensive CR program. Eleven CVD risk factors were assessed at CR entry and completion. Tobacco use was assessed by self-report at CR entry. The primary outcomes were attainment of goal levels for each risk factor. Fewer current and former tobacco users reached the preset goal for Maximal Exercise Capacity. Fewer women than men reached the preset goal for HDL. Women who were current or former tobacco users were less likely to meet the target goals for Triglycerides and more likely to meet target goals for Total Cholesterol and Non-HDL Cholesterol. This preliminary study suggests the importance of identifying the effect of tobacco use and gender on CR outcomes and the need to evaluate modification of key cardiovascular risk factors for subgroups of cardiac patients.
    Journal of Substance Use 03/2014; 19(1-2):171-175. DOI:10.3109/14659891.2013.765515 · 0.48 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract This study aimed to determine the frequency and sociodemographic/clinical correlates of insomnia in Chinese patients aged ≥60 years suffering from chronic obstructive pulmonary disease (COPD). In this case-control study of 142 outpatients with COPD and 218 sex- and age-matched control subjects, COPD patients were recruited from a prospective study sample hospitalized in Hong Kong for acute COPD exacerbation (≥2 major COPD symptoms or >1 major+minor COPD symptoms for ≥2 consecutive days). Controls were recruited from social centres in Hong Kong. Activity of daily living was assessed with the Instrumental Activities of Daily Living Scale, life events were evaluated using the Life Event Scale, depressive symptoms were ascertained with the Geriatric Depression Scale, and quality of life was measured using the Medical Outcomes Study Short Form-12. Early, middle and late insomnia were measured using items 4, 5 and 6 of the Hamilton Rating Scale for Depression. The frequency of ≥1 type of insomnia was 47.2% in patients and 25.7% in controls; frequencies of early, middle and late insomnia in patients were 24.6%, 31.0%, and 26.1%, respectively, compared to 14.7%, 14.7% and 11.9% in controls. Group differences were non-significant after controlling for relevant covariates. However, in multiple logistic regression analysis, more physical illnesses (p = 0.02, OR = 1.3, 95% CI = 1.1-1.7) and more severe depressive symptoms (p = 0.009, OR = 1.1, 95% CI = 1.03-1.3) were independently associated with any type of insomnia in COPD patients, accounting for 21.3% of the variance. A significant proportion of older adult Chinese COPD patients suffer from insomnia that warrants more attention in clinical practice.
    COPD Journal of Chronic Obstructive Pulmonary Disease 12/2013; 11(3). DOI:10.3109/15412555.2013.858314 · 2.73 Impact Factor

Full-text

Download
9 Downloads
Available from
Dec 19, 2014