COPD

Instruct patients with chronic obstructive pulmonary disease and asthma to discard their rescue albuterol inhalers 2 to 3 months after opening.

In adults who present with persistent cough following an upper respiratory tract infection but who have no history of asthma or chronic obstructive pulmonary disease, lung findings are usually “normal” on auscultation.

Almost 90% of employers consider employee medication compliance to be a prime health management objective, according to a study by the National Pharmaceutical Council (NPC).1 The majority of study respondents reported that they are analyzing or have plans to analyze prescription data to determine medication compliance for select health conditions.

Since the 2006 launch of the Medicare Part D prescription drug benefit, the Centers for Medicare & Medicaid Services (CMS) has required all Part D sponsors, including Health Net, to offer free medication therapy management program (MTMP) services to members at high risk for drug-related problems.

Inhaled medications are the cornerstoneof therapy for most of themore than 30 million Americanswho have asthma or chronic obstructivepulmonary disease(COPD). Unfortunately, many ofthese patients use aerosol deliverydevices incorrectly.

Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of these drugs is prominent in patients with chronic pain. Recognition and early prevention of misuse helps physicians identify the causes and proceed with patient care. Most persons with chronic pain have a significant medical comorbidity (eg, asthma) that affects treatment decisions.

The federal government has less authority to set Medicare drug reimbursement prices than officials at the Centers for Medicare & Medicaid Services (CMS) had thought, according to a ruling by Judge Henry H. Kennedy Jr of the US District Court in Washington, DC, in a case (Hays v Leavitt [1:08-cv-01032-HHK]) filed by a person with chronic obstructive pulmonary disease. The patient, Ilene Hays, had received a prescription for DuoNeb, a combination inhalation drug made by Mylan’s Dey subsidiary.

For 1 month, a 66-year-old man had had an asymptomatic lesion on the dorsum of his left hand. The flesh-colored, dome-shaped, maroon-crusted lesion measured 0.7 cm and was located over the fourth knuckle. The patient had chronic obstructive pulmonary disease but was otherwise in good health. He was seronegative for HIV.

Heart failure (HF) is a complex clinical syndrome in whichthe heart is unable to deliver adequate cardiac output at normal fillingpressures. There are proven pharmacological and clinical management strategiesthat can improve care and reduce associated health care costs, but these areunderutilized. The Advanced Heart Failure Program (AHFP) was developed at theDorn Veterans Administration Medical Center to provide a comprehensivemultidisciplinary management approach to persons with advanced HF. Beforeenrollment in the AHFP, the average annual all-cause hospital admission rate was3.2 for the 217 HF patients. After enrollment in the AHFP and stabilization, themean all-cause hospital admission rate was 1.2. HF patients had an averageannual hospitalization cost of $28,936.32 before enrollment in the AHFP. Afterenrollment, average hospitalization cost dropped to $10,851.12 per patient.Taking into account the 50-week cost of $3036.14 for a patient enrolled in theclinic, participation in the AHFP was associated with a significant decrease inthe number of HF-related admissions, saving an average of $15,049.06 perpatient. (Drug Benefit Trends. 2008;20:54-59)

Diabetes is a destructive disease that kills thousands eachyear in the United States and disables thousands more, and its incidence hasbeen rising dramatically. Glycemic control is imperative to forestallcomplications; however, it can be difficult for patients to achieve glycemicgoals.

An obese 61-year-old man with a history of heroin abuse was brought to the hospital after he had fallen onto his buttocks on a sidewalk. He was able to stand initially, but weakness and numb-ness in his legs rendered him suddenly unable to walk or prevent himself from voiding. He denied abdominal or back pain. His medical history included asthma, chronic obstructive pulmonary disease, and hypertension.

Although the hospitalist model is rapidly altering inpatient care-an estimated 29% of American hospitals have hospitalists on staff and more than 12,000 hospitalists practice in the United States-little information about the clinical and economic outcomes of care by hospitalists is available.

LEIDEN, Netherlands - The first complete overhaul of chronic obstructive pulmonary disease (COPD) guidelines eliminated a staging category and made recommendations for antibiotic use during exacerbations.

TUCSON, Ariz. -- For many adults with poor airway function or COPD, the genesis of the problem may have been in the womb, researchers reported.

ABERDEEN, Scotland -- COPD patients may be as much at risk from air pollution inside their homes as they are outside, researchers found.

TORONTO -- Ambulatory oxygen, a big-ticket item for Medicare, may not be all it's cracked up to be for chronic obstructive pulmonary disease without resting hypoxemia.

ANN ARBOR, Mich.-- Only one in three patients who are told they have chronic obstructive pulmonary disease (COPD) have had that diagnosis confirmed with spirometry.

ANN ARBOR, Mich. -- Chronic obstructive pulmonary disease (COPD) with severe emphysema strikes women harder than men on clinical and physiological measures, researchers here affirmed.

My patient is an 82-year-old woman with a history of coronary artery bypass grafting (CABG), chronic obstructive pulmonary disease (COPD), pulmonary hypertension, and mild intermittent angina on exertion, which is relieved by sublingual nitroglycerin.

MONTREAL -- Chronic obstructive pulmonary disease patients who inhaled corticosteroids had a 70% increase in the risk of pneumonia hospitalization over those not given the drugs, researchers here reported.

CARDIFF, Wales -- Premature arterial stiffness and bone aging in patients with chronic obstructive pulmonary disease (COPD) may explain why they are at greater risk for cardiovascular disease, researchers reported.

Does adding an inhaled corticosteroid to treatment with a long-acting ß2-agonist help prevent exacerbations of chronic obstructive pulmonary disease (COPD)? According to Kardos and associates, the answer is yes.

SAN FRANCISCO -- Inhaled corticosteroid and long-acting beta2 agonist therapy significantly slows the progressive lung function decline of chronic obstructive pulmonary disease (COPD).

SAN FRANCISCO -- Nebulized formoterol (Perforomist) appears to treat chronic obstructive pulmonary disease as effectively as the dry-powder formulation (Foradil), researchers said here.

BOSTON -- The so-called Mediterranean diet -- high in fruits, vegetables, fish, and whole grains -- is associated with a 50% reduction in the risk of chronic obstructive pulmonary disease, according to researchers here.

OMAHA, Neb. -- Infliximab (Remicade), the tumor necrosis-factor alpha inhibitor, has proved ineffective for moderate to severe chronic obstructive pulmonary disease.

NEW YORK -- Eating too much bacon and sausage may increase the risk of chronic obstructive pulmonary disease, found researchers here.

ALBUQUERQUE, N.M. -- Moderate use of statins is associated with a sharply reduced risk of death from chronic obstructive pulmonary disease, researchers here found.

SEATTLE -- High doses of inhaled corticosteroids may reduce the risk of lung cancer in men with chronic obstructive pulmonary disease, suggested researchers here.

Sleep complaints are common in patients with chronic obstructive pulmonary disease (COPD). Many patients complain of morning tiredness, early awakenings, difficulty in falling asleep, restlessness, and daytime sleepiness. Functional status may eventually be impaired by the resulting chronic fatigue that is compounded by dyspnea.