Survey to determine the efficacy and safety of guideline-based pharmacological therapy for chronic obstructive pulmonary disease patients not previously receiving maintenance treatment

<div><p><b><i>Objective:</i></b> To investigate the potential beneficial effects of guideline-based pharmacological therapy on pulmonary function and quality of life (QOL) in Japanese chronic obstructive pulmonary disease (COPD) patients without prior treatment.</p><p><b><i>Research design and methods:</i></b> Multicenter survey, open-label study of 49 Japanese COPD patients aged ≥ 40 years; outpatients with >10 pack years of smoking history; ratio of forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) < 70%; predicted FEV₁ < 80%; treated with bronchodilators and/or inhaled corticosteroids as maintenance therapy until week 48.</p><p><b><i>Main outcome measures:</i></b> The primary endpoint was change in pulmonary function (trough FEV₁, trough FVC); secondary endpoints were QOL and physical activity at 48 weeks after initiation of therapy.</p><p><b><i>Results:</i></b> Airway reversibility was confirmed in untreated patients. Significant changes over time were not observed for FEV₁ and FVC, indicating lung function at initiation of treatment was maintained during the observation period. COPD assessment test scores showed statistical and clinical improvements. Cough, sputum, breathlessness, and shortness of breath were significantly improved.</p><p><b><i>Conclusions:</i></b> Lung function and QOL of untreated Japanese COPD patients improved and improvements were maintained by performing a therapeutic intervention that conformed to published guidelines.</p></div

Asthma control status by GINA treatment steps (n=437).

<p>TC denotes total control; WC denotes well control; PC denotes poor control.</p

Life environmental qualities of study subjects.

*<p>Pandemic period, between April 2009 and July 2010; Post-pandemic period, between August 2010 and the end of survey period.</p>†<p>Location was defined by the accessibility of public service which is also followed by the Social Gap Index.</p

Factors relating to delayed seeking of health care, using multivariate analysis.

*<p>House constructed of concrete, tinplate, and combination of concrete and tinplate.</p

Additional file 1: of Chronological, geographical, and seasonal trends of human cases of avian influenza A (H5N1) in Vietnam, 2003–2014: a spatial analysis

Geographical disease clustering of incidence and mortality of human H5N1 infection in Vietnam between 2007 and 2014. (JPG 113 kb

Availability of information related to influenza A(H1N1)pdm09.

*<p>Pandemic period, between April 2009 and July 2010; Post-pandemic period, between August 2010 and the end of survey period.</p

Detailed economic status of study subjects.

*<p>Pandemic period, between April 2009 and July 2010; Post-pandemic period, between August 2010 and the end of survey period.</p>†<p>Income can pay for expense of utilities; light, gas, water, sewerage, telephone.</p>‡<p>Income can pay for expense of food; meat, egg, milk, cereals, vegetable.</p>§<p>Governmental insurance included workers in private organizations.</p

General and health-related backgrounds of study subjects.

*<p>Pandemic period, between April 2009 and July 2010; Post-pandemic period, between August 2010 and the end of survey period.</p>†<p>Socioeconomic level evaluated by ability to pay for utilities, food, and medical service: low income, cannot cover electricity, water, telephone, house rent, foods, any medical service; middle income, can cover a part of electricity, water, telephone, house rent, and foods, but not any medical service; high income, can cover utility and adequate goods, and medical services.</p>‡<p>Number of days from symptom onset to initiation of oseltamivir administration.</p

Information sources on avian influenza (H5N1).

<p>The changed percentage of information sources relating to avian influenza (H5N1) on *KAP 1 (pre-educational intervention survey) and †KAP 2 (post-educational intervention survey) at each group.</p

Clinical features of the study patients on admission.

<p>Grouping of patients was based on the number of days from symptom onset to oseltamivir administration: Group 1, ≤2 days; Group 2, 3–7 days; Group 3, 8–14 days; Group 4, >14 days.</p><p>*Cochran-Armitage test.</p><p>†Chest radiological findings.</p