Updates in COPD Management

CE

Strategies for Pharmacists to Overcome Current Challenges and Integrate Novel Maintenance Therapies for the Management of COPD

Pharmacists: 1.00 contact hour (0.1 CEUs)

Released: January 29, 2024

Expiration: January 28, 2025

J. Andrew Woods
J. Andrew Woods, PharmD, BCPS

Activity

Progress
1 2
Course Completed

References

  1. Global Initiative for Chronic Obstructive Lung Disease. 2024 Gold Report. goldcopd.org/2024-gold-report. Accessed January 23, 2024.
  2. National Heart, Lung, and Blood Institute. What is COPD? nhlbi.nih.gov/health/copd. Accessed January 23, 2024.
  3. Murray CJ, Atkinson C, Bhalla K, et al; U.S. Burden of Disease Collaborators. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591-608.
  4. US Burden of Disease Collaborators; Mokdad AH, Ballestros K, Echko M, et al. The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018;319:1444-1472.
  5. COPD Foundation. IMPACT Lung Health 2024. copdfoundation.org/Take-Action/Get-Involved/IMPACT-Lung-Health.aspx. Accessed January 23, 2024.
  6. US Centers for Disease Control and Prevention, Division of Population Health. Chronic disease indicators. Category: chronic obstructive pulmonary disease. nccd.cdc.gov/cdi/rdPage.aspx?rdReport=DPH_CDI.ExploreByTopic&islTopic=COPD&islYear=9999&go=GO. Accessed January 23, 2024.
  7. Wisevoter. Smoking rates by state. wisevoter.com/state-rankings/smoking-rates-by-state. Accessed January 23, 2024.
  8. US Centers for Disease Control and Prevention. What is COPD? cdc.gov/copd/index.html. Accessed January 23, 2024.
  9. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress. Centers for Disease Control and Prevention; 2014.
  10. Stolz D. Chronic obstructive pulmonary disease risk: Does genetics hold the answer? Lancet Respir Med. 2020;8:653-654.
  11. Ding Y, Li Q, Wu C, et al. TERT gene polymorphisms are associated with chronic obstructive pulmonary disease risk in the Chinese Li population. Mol Genet Genomic Med. 2019;7:e773.
  12. The New York Times. Gas stoves are tied to health concerns. Here’s how to lower your risk. nytimes.com/2023/01/11/well/live/gas-stoves-health-risks.html. Accessed January 23, 2024.
  13. Yang IA, Jenkins CR, Salvi SS. Chronic obstructive pulmonary disease in never-smokers: risk factors, pathogenesis, and implications for prevention and treatment. Lancet Respir Med. 2022;10:497-511.
  14. Kingsley SL, Eliot MN, Carlson L, et al. Proximity of US schools to major roadways: a nationwide assessment. J Expo Sci Environ Epidemiol. 2014;24:253-259.
  15. Marchetti N, Garshick E, Kinney GL, et al; COPDGene Investigators. Association between occupational exposure and lung function, respiratory symptoms, and high-resolution computed tomography imaging in COPDGene. Am J Respir Crit Care Med. 2014;190:756-762.  
  16. Agusti A, Faner R. Lung function trajectories in health and disease. Lancet Respir Med. 2019;7:358-364.
  17. Salvi SS, Brashier BB, Londhe J, et al. Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease. Respir Res. 2020;21:50.
  18. David B, Bafadhel M, Koenderman L, et al. Eosinophilic inflammation in COPD: from an inflammatory marker to a treatable trait. Thorax. 2021;76:188-195.
  19. Dunne CL, Elzinga JL, Vorobeichik A, et al. A systematic review of interventions to reduce computed tomography usage in the emergency department. Ann Emerg Med. 2022;80:548-560.
  20. US Preventive Services Task Force. Lung cancer: screening. uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Accessed January 23, 2024.
  21. Johns DP, Walters JA, Walters EH. Diagnosis and early detection of COPD using spirometry. J Thorac Dis. 2014;6:1557-1569.
  22. Smith BM, Kirby M, Hoffman EA, et al; MESA Lung, CanCOLD, and SPIROMICS Investigators. Association of Dysanapsis With Chronic Obstructive Pulmonary Disease Among Older Adults. JAMA. 2020;323:2268-2280.
  23. Bhatt SP, Soler X, Wang X, et al; COPDGene Investigators. Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2016;194:178-178.
  24. Ezponda A, Casanova C, Divo M, et al. Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort. Respirology. 2022;27:286-293.
  25. Singhvi D, Bon J. CT Imaging and comorbidities in COPD: beyond lung cancer screening. Chest. 2021;159:147-153.
  26. Lowe KE, Regan EA, Anzueto A, et al. COPDGene® 2019: Redefining the Diagnosis of Chronic Obstructive Pulmonary Disease. Chronic Obstr Pulm Dis. 2019;6:384-399.
  27. Thomashow BM, Mannino DM, Tal-Singer R, et al. A rapidly changing understanding of COPD: World COPD Day from the COPD Foundation. Am J Physiol Lung Cell Mol Physiol. 2021;321:L983-L987.
  28. Launois C, Barbe C, Bertin E, et al. The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study. BMC Pulm Med. 2012;12:61.
  29. Stenton C. The MCR breathlessness scale. Occup Med (Lond). 2008;58:226-227.
  30. Jones PW, Tabberer M, Chen WH. Creating scenarios of the impact of COPD and their relationship to COPD Assessment Test (CAT™) scores. BMC Pulm Med. 2011;11:42.
  31. Leone FT, Zhang Y, Evers-Casey S, et al. Initiating pharmacologic treatment in tobacco-dependent adults. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020;202:e5-e31.
  32. Farne HA, Cates CJ. Long-acting beta2-agonist in addition to tiotropium versus either tiotropium or long-acting beta2-agonist alone for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;(10):CD008989.
  33. Dransfield MT, Kunisaki KM, Strand MJ, et al. Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;195:324-330.
  34. Wedzicha JA, Decramer M, Seemungal TA. The role of bronchodilator treatment in the prevention of exacerbations of COPD. Eur Respir J. 2012;40:1545-1554.
  35. Mintz M, Barjaktarevic I, Mahler DA, et al. Reducing the risk of mortality in chronic obstructive pulmonary disease with pharmacotherapy: a narrative review. Mayo Clin Proc. 2023;98:301-315.
  36. Han MK, Ye W, Wang D, et al; RETHINC Study Group. Bronchodilators in tobacco-exposed persons with symptoms and preserved lung function. N Engl J Med. 2022;387:1173-1184.
  37. Martinez CH, Mannino DM, Jaimes FA, et al. Undiagnosed obstructive lung disease in the United States. Associated factors and long-term mortality. Ann Am Thorac Soc. 2015;12:1788-1795.
  38. Brightling CE, Monteiro W, Ward R, et al. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2000;356:1480-1485.
  39. Bhatt SP, Rabe KF, Hanania NA, et al. Dupilumab for COPD with type 2 inflammation indicated by eosinophil counts. N Engl J Med. 2023;389:205-214.
  40. Ariel A, Barnes PJ, Maricoto T, et al. Rational use of inhaled corticosteroids for the treatment of COPD: a plain language summary. J Comp Eff Res. 2023;12:e230136.
  41. Chalmers JD, Laska IF, Franssen FME, et al. Withdrawal of inhaled corticosteroids in COPD: a European Respiratory Society guideline. Eur Respir J. 2020;55:2000351.
  42. Watz H, Tetzlaff K, Wouters EF, et al. Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir Med. 2016;4:390-398.
  43. Lee HW, Park J, Jo J, et al. Comparisons of exacerbations and mortality among regular inhaled therapies for patients with stable chronic obstructive pulmonary disease: systematic review and Bayesian network meta-analysis. PLoS Med. 2019;16:e1002958.
  44. Anzueto A, Barjaktarevic IZ, Siler TM, et al. Ensifentrine, a novel phosphodiesterase 3 and 4 inhibitor for the treatment of chronic obstructive pulmonary disease: randomized, double-blind, placebo-controlled, multicenter phase III trials (the ENHANCE Trials). Am J Respir Crit Care Med. 2023;208:406-416.
  45. Pavord ID, Chapman KR, Bafadhel M, et al. Mepolizumab for eosinophil-associated COPD: analysis of METREX and METREO. Int J Chron Obstruct Pulmon Dis. 2021;16:1755-1770. 
  46. Criner GJ, Celli BR, Brightling CE, et al. Benralizumab for the prevention of COPD exacerbations. N Engl J Med. 2019;381:1023-1034.
  47. National Heart, Lung, and Blood Institute. COPD research. nhlbi.nih.gov/research/copd. Accessed January 23, 2024.
  48. Leeds Centre for Respiratory Medicine. The Leeds inhaler device guide: inhaler technique instructions for healthcare professionals and patients. cpwy.org/wp-content/uploads/sites/128/2022/03/4.-Leeds-Inhaler-Device-Instruction-Guide-vs-11-Final.pdf. Accessed January 23, 2024.
  49. Mosenifar Z. Chronic obstructive pulmonary disease (COPD) treatment & management. Medscape. emedicine.medscape.com/article/297664-treatment?form=fpf. Accessed January 23, 2024.
  50. Mahler DA, Halpin DMG. Personalizing selection of inhaled delivery systems in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2023;20:1389-1396.
  51. Hsiao YH, Tseng CM, Sheu CC, et al. Shared decision-making facilitates inhaler choice in patients with newly-diagnosed chronic obstructive pulmonary disease: a multicenter prospective study. Int J Chron Obstruct Pulmon Dis. 2022;17:2067-2078.
  52. Bosnic-Anticevich S, Chrystyn H, Costello RW, et al. The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes. Int J Chron Obstruct Pulmon Dis. 2016;12:59-71.
  53. Maricoto T, Santos D, Carvalho C, et al. Assessment of poor inhaler technique in older patients with asthma or COPD: a predictive tool for clinical risk and inhaler performance. Drugs Aging. 2020;37:605-616.
  54. Ghosh S, Ohar JA, Drummond MB. Peak inspiratory flow rate in chronic obstructive pulmonary disease: implications for dry powder inhalers. J Aerosol Med Pulm Drug Deliv. 2017;30:381-387.
  55. Mahler DA, Niu X, Deering KL, et al. Prospective evaluation of exacerbations associated with suboptimal peak inspiratory flow among stable outpatients with COPD. Int J Chron Obstruct Pulmon Dis. 2022;17:559-568.
  56. American Lung Association. How to use a metered-dose inhaler without a valved holding chamber. lung.org/lung-health-diseases/lung-disease-lookup/asthma/treatment/devices/metered-dose-inhaler. Accessed January 23, 2024.
  57. American Lung Association. How to use a Respimat Softmist inhaler. lung.org/lung-health-diseases/lung-disease-lookup/asthma/treatment/devices/respimat. Accessed January 23, 2024.
  58. National Heart, Lung, and Blood Institute. Live a heart-healthy life with DASH (Dietary Approaches to Stop Hypertension). nhlbi.nih.gov/sites/default/files/publications/How-to-Use-a-Dry-Powder-Inhaler_21-HL-8164.pdf. Accessed January 23, 2024.
  59. Alliance Tech Medical. In-Check™ DIAL G16: inhaler technique training and assessment tool. alliancetechmedical.com/check-dial-training-device. Accessed January 23, 2024.
  60. Kocks J, Bosnic-Anticevich S, van Cooten J, et al. Identifying critical inhalation technique errors in Dry Powder Inhaler use in patients with COPD based on the association with health status and exacerbations: findings from the multi-country cross-sectional observational PIFotal study. BMC Pulm Med. 2023;23:302.
  61. Cho-Reyes S, Celli BR, Dembek C, et al. Inhalation technique errors with metered-dose inhalers among patients with obstructive lung diseases: a systematic review and meta-analysis of U.S. studies. Chronic Obstr Pulm Dis. 2019;6:267-280.
  62. Dantic DE. A critical review of the effectiveness of ‘teach-back’ technique in teaching COPD patients self-management using respiratory inhalers. Health Educ J. 2014;73:41-50.
  63. Świątoniowska N, Chabowski M, Polański J, et al. Adherence to therapy in chronic obstructive pulmonary disease: a systematic review. Adv Exp Med Biol. 2020;1271:37-47.
  64. Volerman A, Carpenter D, Press V. What can be done to impact respiratory inhaler misuse: exploring the problem, reasons, and solutions. Expert Rev Respir Med. 2020;14:791-805.
  65. Verywell Health. Inhalers for COPD: 15 inhaler options for chronic obstructive pulmonary disease. verywellhealth.com/common-copd-inhalers-915048. Accessed January 23, 2024.
  66. Maricoto T, Madanelo S, Rodrigues L, et al. Educational interventions to improve inhaler techniques and their impact on asthma and COPD control: a pilot effectiveness-implementation trial. J Bras Pneumol. 2016;42:440-443.
  67. Göriş S, Taşci S, Elmali F. The effects of training on inhaler technique and quality of life in patients with COPD. J Aerosol Med Pulm Drug Deliv. 2013;26:336-344.
  68. Leving MT, van Boven JFM, Bosnic-Anticevich SZ, et al. Suboptimal peak inspiratory flow and critical inhalation errors are associated with higher COPD-related healthcare costs. Int J Chron Obstruct Pulmon Dis. 2022;17:2401-2415.
  69. Paulin LM, Williams D, Oberweiser C, et al. Indoor air quality in central Appalachia homes impacted by wood and coal use. J Environ Prot (Irvine, Calif). 2013;4:67-71.
  70. Press VG, Au DH, Bourbeau J, et al. Reducing chronic obstructive pulmonary disease hospital readmissions. an official American Thoracic Society workshop report. Ann Am Thorac Soc. 2019;16:161-170.