Respiratory Self-Care:Identifying Current Challenges and Future Potentials for Digital Technology to Support People with Chronic Respiratory Conditions

Chronic respiratory conditions (CRCs) are life-long diseases affecting millions of people worldwide. They have a huge impact on individuals’ everyday lives, resulting in a number of physical and emotional challenges. Self-management interventions for CRCs are thought to provide empowerment and improve quality of life. However, despite the number of people living with CRCs, most self-management tools in previous HCI work have been designed without the insight of those affected by the conditions. In this paper, we contribute to the literature by investigating the experiences and everyday challenges faced by those with CRCs, through the involvement of 156 participants via interviews and an anonymous survey. Our findings reveal the self-care challenges of CRCs and the reactive management approaches taken by participants. We conclude by providing a set of design implications that support the design of future self-management tools for CRCs

Guidelines for the management of chronic obstructive pulmonary disease

AbstractChronic obstructive pulmonary disease (COPD) is a respiratory condition characterized by progressive decline in lung function. It imposes a considerable burden on patients, healthcare services and society that is likely to increase in the future. It is, therefore, important to ensure that this disease is managed as effectively as possible.In many therapeutic areas, management guidelines have been developed in an attempt to ensure that physicians are aware of optimal disease management and cost-effective use of healthcare resources. Such guidelines are usually prepared by consensus among clinical experts or following a systematic review of the evidence. However, there are a number of barriers to the implementation of treatment guidelines, including the sheer weight of guidelines in all therapeutic areas, a focus on scientific knowledge rather than on clinical practice, lack of trust in the recommendations, practical considerations (e.g. time, resources, budget) and failure to include the perspective of patients.The management guidelines most likely to be implemented are those that are quick and easy to use, relevant to the user's practice and from a credible source.In COPD, over 40 guidelines have been developed, mainly by local respiratory societies as a result of local expert consensus.The guidelines developed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) are evidence-based and have the backing of international experts. Local implementation plans have been developed to help ensure that GOLD recommendations are implemented in practice. In all COPD guidelines, however, lung function measures feature prominently, with limited reference to outcome measures of interest to patients and healthcare payers (e.g. frequency of exacerbations requiring hospitalization). Low expectations among physicians and patients may also impair implementation. In conclusion, guidelines may improve the management of COPD, but the main challenge is to ensure implementation

Modelling slow wave activity in the small intestine

10.1016/j.jtbi.2006.03.004Journal of Theoretical Biology2422356-362JTBI

Comparison of spirometry criteria for the diagnosis of COPD: Results from the BOLD study

PubMedID: 19460786Published guidelines recommend spirometry to accurately diagnose chronic obstructive pulmonary disease (COPD). However, even spirometry-based COPD prevalence estimates can vary widely. We compared properties of several spirometry-based COPD definitions using data from the international Burden of Obstructive Lung Disease (BOLD)study. 14 sites recruited population-based samples of adults aged ?40 yrs. Procedures included standardised questionnaires and post-bronchodilator spirometry. 10,001 individuals provided usable data. Use of the lower limit of normal (LLN) forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio reduced the age-related increases in COPD prevalence that are seen among healthy never-smokers when using the fixed ratio criterion (FEV1/FVC <0.7) recommended by the Global Initiative for Chronic Obstructive Lung Disease. The added requirement of an FEV1 either <80% predicted or below the LLN further reduced age-related increases and also led to the least site-to-site variability in prevalence estimates after adjusting for potential confounders. Use of the FEV1/FEV6 ratio in place of the FEV 1/FVC yielded similar prevalence estimates. Use of the FEV 1/FVC<LLN criterion instead of the FEV1/FVC <0.7 should minimise known age biases and better reflect clinically significant irreversible airflow limitation. Our study also supports the use of the FEV 1/FEV6 as a practical substitute for the FEV 1/FVC. Copyright©ERS Journals Ltd 2009

Restricted spirometry in the burden of lung disease study

PubMedID: 22863565BACKGROUND: The presence of restrictive lung disease has classically required the measure of total lung capacity to document 'true' restriction, which has limited its detection in large population-based studies. METHODS: We used spirometric data to classify people with restricted spirometry (forced expiratory volume in 1 second [FEV1]/forced vital capacity ? 0.70 and FEV1 < 80% predicted) in the Burden of Lung Disease (BOLD) Study and determined the relation between this finding and demographic factors and the presence of chronic diseases, including diabetes mellitus, hypertension and cardiovascular disease. RESULTS: Overall, we found that 11.7% of men (546/ 4664) and 16.4% of women (836/5098) had restricted spirometry. Prevalence varied widely by site, from a low of 4.2% among males in Sydney, Australia, to a high of 48.7% among females in Manila, The Philippines. Compared to people with normal lung function, those with restricted spirometry had a higher prevalence of diabetes (12.2% vs. 4.6%), heart disease (15.0% vs. 7.7%) and hypertension (38.8% vs. 22.8%). CONCLUSIONS: Restricted spirometry is a common finding in population studies. Additional research is needed to better define and describe the mechanisms that lead to restricted spirometry and potential interventions. © 2012 The Union