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Coronavirus disease 2019 (Covid 19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV 2) and causes lymphopenia, immunosuppression, inefficient T and B cell immunity, cytokine storm, and destructive tissue inflammation. Since COVID 19 is a multi-system disease predominantly affecting the lungs, there is doubt on whether chronic lung diseases place patients at higher risk and SARS CoV2 leads to asthma exacerbation. None of the studies have reported asthma or recurrent wheezing as a comorbidity or risk factor for Covid 19 in children up to now. Notably, further studies are needed to explore the relationship between Covid 19 and asthma to improve clinical practice and decrease morbidity and mortality.Copyright © 2020 Bilimsel Tip Yayinevi. All rights reserved.
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Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.Copyright © 2020 Bilimsel Tip Yayinevi. All rights reserved.
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Background: Little is understood about which comorbidities are associated with severe outcomes in children hospitalized with acute COVID-19. Some confusion lies especially for cancer or diabetes. Method(s): Data from 2 multicenter prospective cohort studies of hospitalized children (aged 0-18 years) with confirmed SARS-CoV-2 in Spain and Colombia were combined for this analysis. Data were obtained from 116 hospitals. Outcome was classified as (in decreasing order of severity): death, mechanical ventilation (MV), pediatric intensive care unit (PICU) admission, high flow/CPAP, oxygen therapy with nasal prong (NP) and hospitalization without respiratory support. Risk factors for severity, adjusting for age and gender, were identified using multinominal logistic regression and a backwards selection process. Result(s): A total of 1,753 patients were included, 734 (41.8%) in Spain and 1,019 (58.1%) in Colombia. The most frequent comorbidities were asthma (9.0%), chronic neurological disorder (NRL) (7.4%), immunosuppressive medication (7.2%), malignant neoplasms (5.4%) and chronic lung disease (not asthma) (CLD) (4.5%). Comorbidities associated with the different endpoints are summarized in Figure 1. Asthma was associated with a significantly increased risk of death (OR: 4.17;95%CI 1.34-12.97), MV (OR: 7.94 (3.59-17.56)), PICU admission (OR: 3.37 (1.91- 5.96)), high flow/CPAP (OR: 6.65 (2.69-16.46)), and NP (OR: 3.85 (2.57-5.77)) compared to hospitalization without respiratory support. NRL was associated with increased risk of death (OR: 7.34 (3.01-17.90)), MV (OR: 3.07 (1.20-7.82)) and high flow/CPAP (OR: 4.36 (1.68-11.29)). CLD was associated with increased risk of death (OR: 6.22 [2.28-16.94]) and NP (OR: 3.1 (1.74-5.58)) and in addition, chronic cardiac disease was associated with increased risk of MV (OR: 5.21 (1.76-15.41)) and PICU (OR: 2.78 (1.27-6.08)). Risks of death (OR: 4.49 (2.03-9.05)), MV (OR: 2.97 (1.52-5.81)), PICU (OR: 4.27 (2.89-6.33)), and NP (OR: 4.67 (3.64-5.99)) were higher in the Colombia Cohort. Conclusion(s): Asthma, chronic neurological, cardiac and lung disease;and belonging to the Colombia cohort were consistently associated with multiple severe outcomes of COVID-19. Cancer and diabetes association with selected endpoints rather than with most endpoints may be more related to the baseline disease than with the actual COVID-19.
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The COVID‑19 pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. Several studies have linked the severity of COVID‑19 to risk factors such as age, male, hypertension, diabetes, obesity, cardiovascular disease, liver and kidney disease, cancer, and pregnancy. The association between chronic obstructive pulmonary disease (COPD) and asthma, the most common chronic airway inflammatory diseases in the population, and SARS‑CoV‑2 infection is not yet clear. This article will review the comorbidity rates of COPD and asthma in COVID‑19 patients, their effects on COVID‑19, and the possible mechanisms, in order to provide scientific data for clinical practice. © 2022 Editorial Board of Medical Journal of Wuhan University. All rights reserved.
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Objectives: The aim of the study was to identify factors associated with the development of COVID-19 in healthcare professionals at a university hospital at the onset of the pandemic. Material(s) and Method(s): Cross-sectional study using an online survey validated in aspect and content, cognitive pre-test and piloting aimed at healthcare professionals. Absolute and relative frequencies were described for qualitative and quantitative variables, associations were analyzed using the chi-square test for qualitative variables and Student's t-test for quantitative variables. Logistic regression was performed to identify factors associated with COVID-19 in healthcare professionals. Result(s): 728 workers participated in the survey. Statistically significant differences were observed in type of work (p=0.041), exposure related to spaces and organisation (p=0.001), previous pathology (p=0.029) and asthma (p=0.034). Healthcare professionals working in care areas of the hospital were most likely to develop COVID-19 (OR: 2.02;p=0.027) and also in those with exposure related to space and organisation (OR: 2.13;p<=0.001). Conclusion(s): Healthcare professionals who worked in care areas of the hospital were twice as likely to develop COVID-19.The same was observed for those with space-related exposure.Copyright © 2023, Accion Medica S.A.. All rights reserved.
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Introduction/Aim: Progress in achieving the Goals and Objectives of the National Asthma Strategy was measured using 10 national asthma indicators. The status of asthma in Australia was shown using indicators covering prevalence, mortality, hospital and emergency department (ED) visits and treatment and management. Findings are based on historical data up to the most recent data available so that progress could be assessed. Method(s): Data for each indicator has been sourced from the National Health Survey, Medicare Benefits Schedule, Pharmaceuticals Benefits Scheme, National Hospital Morbidity and Mortality Databases. Relevant analysis has been conducted to show changes over time and variation in progress across priority population groups. Result(s): In 2020-2021, 2.7 million Australians were living with asthma. Hospitalisations due to asthma declined between 2016-2017 and 2020-2021 by over 40%. ED visits also declined between 2018-2019 and 2019-2020 by about 10%. However variation can be seen in the use of these services across the country. These findings are potentially attributable to an indirect impact of the COVID-19 pandemic and the health protection measures put in place. Results also include data on mortality, use of General Practitioner services and the use of medicines to treat and manage asthma, psychological distress experienced by people with asthma, and interference of asthma on daily activities. Conclusion(s): Some favourable outcomes in some indicators show progress towards achieving the Goals and Objectives of the National Asthma Strategy. However, some results were impacted indirectly for the COVID-19 pandemic and variation across Australia can be demonstrated. Improved data is needed to understand the treatment and management of asthma in primary health care.
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Purpose of study The IMPACT DC Asthma Clinic is an intervention program designed to transition children who are heavily dependent on the emergency department for episodic care to more effective longitudinal asthma care in their primary medical homes. We sought to study the implementation of a telemedicine model for IMPACT DC during the COVID-19 pandemic in order to address barriers to care. Methods used A telemedicine model of IMPACT DC was implemented using rapid-cycle improvements and process mapping. Measures for adoption of services including visit completion, show rates, primary language, and patient satisfaction were collected for six months. Healthcare utilization data for the six months prior to the IMPACT DC clinical intervention was collected. This data was compared to in- person clinic visits over the same six-month period the previous year. Summary of results 360 patients successfully completed a telemedicine visit between April 2020 and September 2020 with an average visit show rate of 52%. Primary language was English in 89%. These patients were most frequently classified as having mild-persistent asthma and were assessed as well-controlled. Satisfaction survey response rate was 33%;overall average satisfaction was high. In the comparison group, 701 patients successfully completed an in-person clinic visit between April 2019 and September 2019 with a visit show rate of 39%. Primary language was English in 84%. These patients were most frequently classified as having mild-persistent asthma, not well-controlled. Healthcare utilization data for both groups six months prior to their visit are displayed Conclusions The use of telemedicine provides IMPACT DC a feasible and adoptable model to continue caring for children with asthma, with overall high patient satisfaction. This model addresses access barriers during the pandemic, and promises to be an adjunctive tool for reaching families with low show rates and high healthcare utilization. (Table Presented).
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Introduction/Aim: Asthma remains the leading cause of chronic respiratory illness among Native Hawaiian (NH) adults in Hawaii. People with moderate to severe asthma are at a higher risk for developing severe respiratory symptoms caused by COVID-19. The United States Center for Disease Control and Prevention recommends that people with asthma take extra precautions to prevent exposure to COVID-19. These recommendations include social/physical distancing, avoiding large crowds, staying home whenever possible, controlling asthma with medications and using an asthma action plan. The purpose of this study is to describe the impact COVID-19 had on asthma and asthma management among Native Hawaiian adults in Hawaii. Method(s): A qualitative interview using a cultural approach of kukakuka (talk story) was conducted to learn more about how participants managed their asthma since March 2020 and to understand the impact COVID-19 had on their management. Thematic content analysis was used to identify main themes. Result(s): 25 interviews were conducted between October 2021 and September 2022. Participants self-identified as Native Hawaiian and resided within the State of Hawaii. Ages ranged from 22 to 87 with majority of participants identifying as female. Three main themes emerged from the 25 participant interviews. The themes included: (1) asthma support, (2) lifestyle strategies to manage asthma, and (3) worry over COVID-19. Conclusion(s): The impact of COVID-19 increased preventative behaviors among Native Hawaiian adults with asthma. Participant's worry over COVID-19 resulted in vigilant behaviour with a reduction in reported asthma episodes. In addition, participants adjusted their lifestyle and found support through technology. These findings lend itself to developing a survey to explore behavioural practices related to prevention of other respiratory illnesses which can exacerbate asthma such as the seasonal flu as well as on-line resources to provide preventative strategies to reduce illness transmission.
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Asthma is one of the most common chronic respiratory diseases in the world and there is great concern about the effect of COVID-19 infection on asthma severity and control. Although the link between asthma and COVID-19 infection remains to be determined, available data indicate that asthma does not seem to be a risk factor for severe COVID-19. This review aims to summarize the updated data about the association between viral infections and asthma exacerbations including COVID infection and management of asthma flare-ups during the COVID pandemic, based on the recommended asthma guidelines.Copyright © 2020 Bilimsel Tip Yayinevi. All rights reserved.
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Introduction: The aim of this study is to comprehensively evaluate the incidence and natural course of otorhinolaryngological symptoms of COVID-19 infection and its relations to each other and patient's demographics. Method(s): This is a prospective study conducted on symptomatic adult patients proven to be infected with COVID-19. Detailed history was taken from each patient including onset of symptoms. Symptoms were followed up tightly. We focus on otorhinolaryngological (ORL) symptoms and their duration and onset in relation to other symptoms. Data were collected and analyzed in detail. Result(s): Six-hundred eighty-six patients were included in the study, their age ranged from 19-75 years old, and of them 55.1% were males. Cough was found in 53.1% of cases followed by sore throat in 45.8%, anosmia/ hyposmia in 42.3%, headache in 42%, rhinorrhea in 19.5%, dry mouth in 7.6%, globus in 6.1%, epistaxis in 4.4%, and hearing loss in 0.6%. In non-ORL symptoms, fever was found in 54.2%, malaise in 55.1%, dyspnea in 49.3%, and diarrhea in 27.2%. The first symptom was anosmia in 15.7% of cases, sore throat in 6.1 %, cough in 7.9%, and headache in 13.4% of cases. Fever was the first symptom in 22.7%, malaise in 25.1%, and diarrhea in 6.4%. Headache occurred for 5.5 +/- 2 days, anosmia/hyposmia 3 to > 30 days, sore throat 4.1 +/- 1.2 days, rhinorrhea 4.3 +/- 1.1, cough 7.4 +/- 2.5 days, fever 4.7 +/- 2 days, and malaise 6.5 +/- 2.4 days. The cluster of COVID-19-related symptoms showed nine principal components. Conclusion(s): Otorhinolaryngological symptoms are main symptoms in COVID-19 infection, and they should be frequently evaluated to detect suspected cases especially in pauci-symptomatic patients and to properly manage infected patients.Copyright © 2022, The Author(s).
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Introduction: COVID-19 is a disease with gaps in its knowledge. It is required to explore its clinical manifestations over time and consequences for performance in the working population. Objective(s): To identify the clinico-epidemiological characteristics and the fitness to work in health workers convalescing from COVID-19. Material(s) and Method(s): A prospective longitudinal study was carried out on health workers in Havana. The population consisted of 40 workers who attended the COVID-19 convalescent consultation and were followed up in May 2022. Result(s): Dyspnea (18.8 %), insomnia (18.8 %), and arthralgia (12.5 %) persisted at the end of the year. Hypertension, obesity and bronchial asthma were the main comorbidities. In addition, 100 % of workers were fit for work. Conclusion(s): PostCOVID-19 symptoms deceased considerably 8 months after the onset of the disease;dyspnea, arthralgia, and insomnia persisted at the end of the year.Copyright © 2022 Universidad de Ciencias Medicas de La Hab. All rights reserved.
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Antibiotics play an essential role in antimicrobial therapy. Among all the medications in children, the most commonly prescribed therapy is antibiotics and is currently the indispensable means to cure transmissible diseases. Several categories of antibiotics have been introduced into clinical practice to treat microbial infections. Reducing the unnecessary use of antibiotics is a global need and priority. This article aims to provide better knowledge and understanding of the impact of the early use of antibiotics. This article highlights the proper use of antibiotics in chil-dren, detailing how early and inappropriate use of antibiotics affect the gut microbiome during normal body development and consequently affect the metabolism due to diabetes mellitus, obe-sity, and recurrence of infections, such as UTI. Several new antibiotics in their development stage, newly marketed antibiotics, and some recalled and withdrawn from the market are also briefly discussed in this article. This study will help future researchers in exploring the latest information about antibiotics used in paediatrics.Copyright © 2023 Bentham Science Publishers.
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The lung is the most common organ affected by sarcoidosis. Multiple tools are available to assist clinicians in assessing lung disease activity and in excluding alternative causes of respiratory symptoms. Improving outcomes in pulmonary sarcoidosis should focus on preventing disease progression and disability, and preserving quality of life, in addition to timely identification and management of complications like fibrotic pulmonary sarcoidosis. While steroids continue to be first-line therapy, other therapies with fewer long-term side-effects are available and should be considered in certain circumstances. Knowledge of common clinical features of pulmonary sarcoidosis and specific pulmonary sarcoidosis phenotypes is important for identifying patients who are more likely to benefit from treatment.Copyright © ERS 2022.
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Background: Medical teams are experiencing unprecedented stressors as a result of the COVID-19 pandemic. In the face of these pressures, teamwork has become more important and more challenging. Focused attention on teamwork is required. Cystic fibrosis clinical research programs across the country have struggled with team dynamics during the pandemic, and attention to how the team interacts is important. The clinical research program in pediatric pulmonary disease at Rainbowconsisted of two teams (cystic fibrosis (CF), asthma and other pulmonary disease). We identified the struggle during the pandemic of losing touch with our team because of staggered schedules, the way studies were assigned, and separation of the teams in the program. Research coordinators (RCs) were working in silos that led to one RC being very busy while others might not be busy. A survey of four RCs revealed that the top four challenges they faced as individuals were completing tasks effectively, work distribution, communication, and lack of transparency. The top three challenges they faced as a team were communication, doing things "on the fly" (not planning ahead), and workload equity between team members. Method(s): The objective was to create an environment in which everyone worked together for a common goal: advancing clinical trials to support our patients through improved team dynamics with a shared vision. To accomplish this goal, we adapted our research program to include staff from all of the Pediatric Pulmonology Disease Division, allowing us to have six RCs who can move between multiple studies. The clinical research operations manager (CROM) assigns the teams during study startup. Teams of three RCs and one regulatory coordinator are assigned to each study. During startup, delegation of responsibilities is decided with the aid of a startup and implementation checklist. The three-person teams rotate to allowall team members to work with and support each other. The RCs have no regulatory responsibilities, and the Support Services team meets most processing needs. Weekly huddles are held to review visits and discuss coverage and logistics for the upcoming week. To further develop the team dynamic, a huddle is reservedweekly to reviewa study or logistics of a new or ongoing study. The entire team also meetsweekly, including the primary investigators, to review the status of studies at various stages of the clinical research cycle. Result(s): The pediatric pulmonary team model was implemented in September 2021;since then, 13 studies have migrated to the team-based approach. This model has helped the team dynamic significantly by taking a team-based approach rather than working in silos within the program. It has allowed work to be spread more evenly across the team and enhanced the ability to work from home or take time off with short notice. It has also allowed the RCs to focus on areas of research that play to their strengths. Some team members prefer to recruit or do data entry for studies, whereas others prefer to participate in patient-facing visits. Conclusion(s): Team dynamics is an essential consideration for the success of clinical research programs. During a time of isolation and uncertainty, teams can overcome hurdles and become stronger by developing a shared vision and shared responsibilities across several studies. The team model has allowed individuals to work across teams using their strengths and talents.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved
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Objective Asesmentof lung function impairment after mild SARS-CoV-2 infection in non-hospitalized children and adults. Additionally focusing on previous and persistent symptoms due to Covid-19 as well as current respiratory tract infection status. Methods Patients aged 6-60 years were recruited by telephone after laboratory-confirmed positive PCR result for SARS-CoV-2. Excluding criteria were hospitalization during Covid-19, pre-existing lung diseases (bronchial asthma, COPD) and smoking within the last five years. Pulmonary function testing was performed 4-12 weeks after infection, including Multiple-breath washout (LCI), spirometry (FEV?, FVC, Tiffeneau-Index) and diffusion capacity testing (DLCO, TLC;Hb corrected). All patients answered a questionnaire regarding previous and persistent symptoms. To gather information about the current infection status, a pharyngeal swab was taken to detect common respiratory bacterial and viral pathogens using a multiplex PCR approach. Patients with abnormalities in pulmonary function were invited to a follow up testing three months later. Results 110 patients, 90 adults and 20 children, were included. 44 adults and 17 children had at least one abnormal value in pulmonary function tests after an average of 7.7 weeks (range 4.3-11.3) to confirmed SARS-Cov-2 infection. Among these 44 adults, 33 reported pulmonary symptoms during Covid-19 and 19 persistent respiratory symptoms. No abnormalities in DLCO were found in adults. At the second pulmonary function testing 12.5 weeks (range 11.0-16.7) on average after the first appointment, improvement was shown in 61,7% ( n=29 of 47) with previous abnormal LCI, in 69,2% (n=9 of 13) with prior abnormal FVC and in 4 of 5 children with abnormal DLCO. No large correlation was detected between impaired pulmonary function and multiplex PCR results. Conclusion Mild lung function impairment was shown at the first appointment, particularly in LCI, but not equally measured in the entirety of lung function tests. Pulmonary function results were not affected by current infection status and partially mismatching with stated persisting symptoms. Within 3 months, most initially abnormal values improved, and self- perceived health status increased. Long term pulmonary function impairment was rarely detected after mild, non-hospitalized Covid-19 course. .
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Purpose: Infection due to SARS-CoV-2 shows wide spectrum of disease from asymptomatic to severe disease and death. Coinfection of SARS-CoV-2 with other respiratory pathogens may affect the severity of disease and its outcome. Identification of other respiratory pathogens may help to initiate proper management and avoid unnecessary complications. Material(s) and Method(s): Total 250 SARS-COV-2 positive patients admitted in S.M.S hospitalwere included in study. Throat and nasopharyngeal swabs samples were collected in Viral Transport Medium (VTM) and nucleic acid extraction was done by automated EasyMag extractor and tested for 20 respiratory viruses and two bacteria by real time PCR. Result(s): Out of 250 SARS CoV2 positive samples, 176 (70%) were positive for other respiratory pathogens also. The highest co-infection was due to HCoVOC43 (32.8%) virus followed by bacterial co-infection with S. pneumoniae (14.8%). Six (2.4%) patients with co-infection were on ventilator with age >65yr and three (1.2%) died during treatment. All three cases were found to have other co-morbid diseases like;asthma, Parkinson's and hypertension. Conclusion(s): High number of patients were found to have coinfection with other viruses and bacteria, timely identification and providing specific treatment to these patients can help improve outcome.Copyright © 2023 Indian Association of Medical Microbiologists
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Introduction/Aim: The fifth objective of the 2018 National Asthma Strategy called for the development of a national research agenda. Asthma Australia and partners have completed this project: the National Asthma Research Agenda. Method(s): A national, mixed-method study design adapted from the James Lind Alliance Priority Setting Partnership was adopted. Comprising two discrete phases . A cross-sectional purposive survey of people with asthma, their careers, clinicians and public health professional. The survey findings were analysed thematically. Themes containing questions already answered by high quality research were removed. The project executive team approved the remaining list of themes for phase 2. Three consensus workshops were held comprising health and policy professionals, people with asthma, parents and people from diverse backgrounds to achieve consensus on prioritising and ranking the themes. Workshop participants did this under the guidance of a trained/skilled facilitator. The ranked themes from the workshops were filtered through a computer algorithm, resulting in a top ten list of asthma research priority themes. These themes summarise specific topics and questions and form the National Asthma Research Agenda. Result(s): 593 people completed the survey. Most respondents were female and had asthma. The top ten research priority themes are: Asthma in children Asthma and COVID-19 Asthma care and self-management Diagnosis and medication Managing asthma attacks Causes, prevention and features of asthma Mental health Asthma and ageing Severe asthma Asthma and other health conditions These themes include sub-topics, which reflect the specific inputs of the survey participants. Results were consistent among subgroups. Conclusion(s): The end-user methodology used has been useful in determining what's important to the people who rely on the answers provided by asthma research in Australia. This is a broad research agenda, which highlights the extent of research output that consumers require in order to manage asthma.
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Introduction/Aim: Treatable traits based personalised medicine has been shown to improve outcomes in severe asthma clinic. We assessed the feasibility of a randomised controlled trial of protocolised 'focused' and 'extended' treatable trait guided asthma management in patients not under a severe asthma clinic. Method(s): Ten week single-group cohort study. Participants had a doctor's diagnosis of asthma, asthma control questionnaire (ACQ) score >1, and a history of exacerbation in the last year. Patients already under the care of a severe asthma clinic or receiving high-dose inhaled corticosteroids, biological therapy or maintenance oral corticosteroids were excluded. Intervention(s): asthma medication according to application of a 'focused' treatable trait algorithm, targeting type-2 inflammation and airflow obstruction. Feasibility outcomes: recruitment rates, acceptability of intervention, willingness to enrol in a full RCT, need for 'extended' trait assessment after 10 weeks, and estimation of trait prevalence. Result(s): Recruitment ceased after 14 months with 30/50 participants due to difficulties associated with COVID-19. 92% found the intervention acceptable and were willing to be randomised in a future study. 65% remained not well-controlled with an ACQ >1 after 10 weeks and would have required the 'extended' algorithm. Participants had a mean (SD) 4.8(2.3) of 13 traits assessed. Participation in the study was associated with clinically important improvements in ACQ, -1.0 (1.5) units;St George Respiratory Questionnaire, -15.1 (14.7) units;Asthma Quality of Life Questionnaire, +1.0 (1.1) units;and FEV1, +0.4 (0.4) L. Post-bronchodilator airflow obstruction reduced from 60% of participants at study commencement to 35%. 53% of participants were allocated continuous oral corticosteroids at some point during the study. Conclusion(s): Protocolised treatable trait management was acceptable, associated with significant clinical benefit and a full trial appears feasible. Targeting two traits was insufficient to control asthma in the majority of patients over the timeframe of this study, despite significant corticosteroid exposure.
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Introduction: Pulmonary rehabilitation (PR) is an effective treatment for people with chronic respiratory disease but is delivered to <5% of eligible individuals. Home-based telerehabilitation achieves similar clinical outcomes to centre-based PR in clinical trials. We aimed to evaluate the clinical implementation of telerehabilitation. Method(s): Suitable individuals with respiratory disease referred for PR at Alfred Health have been offered the option of an 8-week home-based telerehabilitation program (one home visit followed by twice-weekly exercise training sessions, with real time supervision, for 8-weeks). Equipment was provided to patients, as necessary. Standard PR assessments were conducted pre and post program. Program completion was defined as undertaking >=70% of prescribed sessions. Real-world implementation was evaluated against the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Result(s): Reach: Across 2-years (Sept 2020-22), 269 people were referred with 55 (21%) undertaking telerehabilitation (25 female, mean (SD) age 61 (11) years, 6-min walk distance (6MWD) 430 (120) metres, Chronic Respiratory Questionnaire Dyspnoea (CRQD) domain 16 (6)). Participant diagnoses included COPD (n = 11), ILD (n = 15), bronchiectasis (n = 5), asthma (n = 2), post COVID-19 (n = 9), and pulmonary hypertension (n = 4). Forty participants (73%) completed >=70% of prescribed sessions. Effectiveness: Significant and clinically meaningful improvements were demonstrated (CRQD MD 4 (95% CI 1, 6);6MWD MD 24 m (95% CI 8, 41)). Adoption: Training to deliver telerehabilitation and perform home visits was completed by PR clinicians (n = 7 and n = 4 respectively). Implementation: All participants independently supplied Wi-Fi, and 40% used their own exercise equipment or internet-enabled device. Most participants had an in-person home visit (n = 45), and undertook cycle-based training (n = 46). Fifteen participants required additional support for iPad or videoconferencing navigation. There were no serious adverse advents. Maintenance will be evaluated following this pilot period. Conclusion(s): 'Real-world' telerehabilitation achieves clinically meaningful outcomes for patients and provided access to an effective model of PR particularly when centre-based programs were unavailable due to COVID-19 restrictions.