The annual meeting of the American College of Chest Physicians was held from Oct. 22 to 26 in Los Angeles and attracted approximately 6,000 participants from around the world, including specialists and health care professionals in the fields of pulmonary, critical care, and sleep medicine.
Among patients with frequent exacerbations of asthma and chronic obstructive pulmonary disease (COPD) with a history of noncompliance, D. Richard Allison, N.P., of the University of California, San Francisco, and colleagues found that a single home visit could significantly improve patient adherence to office visits and inhaler use, as well as reduce severe exacerbations requiring emergency department visits.
“When we looked at the impact of the home visit on patient adherence (total office appointments attended and maintenance inhaler use) there was a significant increase in compliance with office visits in the year following the home visit as compared to the year before the home visit (133 versus 68 visits). This was associated with a significant improvement in patient adherence to maintenance inhaler use (63 versus 21 percent),” Allison said. “Increasing compliance with office appointment attendance and medication use has the potential to improve patient outcome, slow progression of the disease, and save overall health care dollars.”
In another study, Stephen Eikermann, D.O., of the Corpus Christi Medical Center in Texas, and colleagues found that the diagnosis of COPD in primary care settings using only physical exam and symptomatology results in significantly reduced diagnostic accuracy and precision.
“Despite every international pulmonary society indicating spirometry is necessary for the diagnosis of COPD, our study found only 29 percent of patients in the primary care setting had spirometry available. Of that group, 31 percent of them were misdiagnosed with COPD when actually asthma, restrictive lung, or normal lungs were found. This demonstrates that the spirometry findings are either being misinterpreted or underutilized,” Eikermann said. “There needs to be better education on several levels to improve primary provider understanding of the GOLD (Global Initiative for Chronic Obstructive Lung Disease) Guidelines and increase accuracy in the diagnosis and treatment of patients with COPD.”
Alvaro Martin, M.D., of SBH Health System Bronx in New York, and colleagues found that less than 40 percent of staff members felt comfortable with the presence of a patient’s family during cardiopulmonary resuscitation (CPR).
“Prior experience with family presence during resuscitation (FPDR), including problems witnessed by the health care staff, was a determinant for the level of acceptance among the surveyed. We also found that the most significant predicting factor was the working area, with fewer personnel from the medical wards feeling comfortable with FPDR compared to those in the emergency department and intensive care unit,” Martin said. “Most surveyed in our study mentioned that they would benefit from a formal training on how to deal with FPDR. We agree that it should be part of the routine training of physicians, nurses, and the rest of the members of a code team.”
Jen Mattingley, M.D., and Kurt Oettel, M.D., of Gundersen Health System in La Crosse, Wis., found that blood-based genomic and proteomic testing can provide results to aid multidisciplinary teams in expediting treatment decisions and facilitating more informed prognostic conversations with newly-diagnosed lung cancer patients.
“There were three main end points to our analysis. The first was determining how quickly results could be made available to support treatment decisions and prognostic conversations. In our patient cohort, all results for blood-based genomic and proteomic testing were available in less than 72 hours (average, 24.1 hours). Second, GeneStrat genomic testing was highly accurate (93 percent sensitivity and 99 percent specificity) and concordant (96 percent) with tissue-based mutation results,” Mattingley said. “Finally, VeriStrat proteomic testing was prognostic for progression-free survival (PFS) and overall survival (OS) across all stages of lung cancer. Patients with a VeriStrat ‘good’ status had significantly longer PFS and OS compared to patients with a ‘poor’ status.”
CHEST: Odds of Certain Post-Op Issues Up With Sleep Apnea
TUESDAY, Oct. 18, 2016 (HealthDay News) — Obstructive sleep apnea (OSA) may increase risk of developing postoperative atrial fibrillation and venous thromboembolism, according to two new studies scheduled for presentation at the annual meeting of the American College of Chest Physicians, held from Oct. 22 to 26 in Los Angeles.
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